Social networks have been a central focus of sociological research on inequalities but less has focused specifically on chronic illness and disability despite a policy emphasis on resources necessary to support self-management. This seeks to unpack overlaps and distinctions between social network approaches and research on the experience and management of chronic illness. It outlines four main areas viewed as central in articulating the potential for future work consistent with a critical realist perspective: (1) body–society connections and realist/relativist tensions; (2) the controversy of ‘variables’ and accounting for social and cultural context in studying networks for chronic illness support; (3) conceptualising social support, network ties and the significance of organizations and technology; and (4) translating theory into method.
Equity in Health
Thousands marched in Cape Town in February in a massive show of support for the demand that the South African government sign and implement a national HIV treatment programme. Estimates on the amount of marchers attending the march organised by AIDS-lobby group the Treatment Action Campaign (TAC) and taking place on the occasion of the opening of South Africa's Parliament for 2003 ranged from between 10 000 and 30 000. The material available through the link below includes a report on the march, a letter from TAC activist Zackie Achmat about the march, the memorandum presented to government and a memorandum to President Bush and Members of US Congress dealing with the Doha agreement.
By Mouhamadou Gueye, Sarah Castle and Mamadou Kani Konaté
The social and economic context in which Malian adolescents begin sexual activity is different from that experienced by previous generations. Little is known about the forces that currently shape adolescents' sexuality and affect their reproductive health.
The South African Medical Association (SAMA) organised a protest march by doctors to the opening of parliament on 6 February. Amongst other grievances, the march was over controversial new legislation that includes a proposed Certificate of Need (CON) that would impact on where doctors are able to practice. SAMA said in the build up to the march that the CON would intrude "on doctors’ right to human dignity; freedom of movement and residence; freedom of trade, occupation and profession; and property rights". This sparked a debate when the Peoples' Health Movement came out in support of the CON, saying it represented an attempt to address the greatest inequity in S.A.'s health system, namely the widening gap between the public and private health sectors. Read the PHM press statement and a report from the SAMA website about the march by clicking on the link below.
In the special United Nations session on AIDS next week, there will be much discussion about international aid, about drugs and vaccines. But there is likely to be too little said about what is the primary means by which AIDS is spread in sub-Saharan Africa: risky heterosexual sex.
Following a meeting today with UN Secretary-General Kofi Annan during the U.N. Special Session on AIDS, leaders of some of the world’s biggest companies, including The Coca-Cola Company and MTV Networks International, announced their commitments to fight the global AIDS epidemic, and called upon other business leaders to join the cause.
Mary Robinson, the first woman President of Ireland (1990-1997) and more recently United Nations High Commissioner for Human Rights (1997-2002) shared with the conference team some of the main challenges at hand when it comes to access to health for all: accountability, financing, the brain drain and the responsibility of those who have the means to make a difference, such as the private sector. She pointed out that the high turnout at the Forum was an indicator of the need for it and the urgency of discussing access to health. Access for all is the concern of all.
The primary objectives of this study were to measure within-country wealth-related inequality in the health service coverage gap of maternal and child health indicators in sub-Saharan Africa and quantify its contribution to the national health service coverage gap. Coverage data for child and maternal health services in 28 sub-Saharan African countries were obtained from the 2000–2008 Demographic Health Survey. The researchers found that, in 26 countries, within-country wealth-related inequality accounted for more than one quarter of the national overall coverage gap. Reducing such inequality could lower this gap by 16% to 56%, depending on the country, they argue. Wealth-related inequality was more common in services such as skilled birth attendance and antenatal care, and less so in family planning, measles immunisation, receipt of a third dose of vaccine against diphtheria, pertussis and tetanus and treatment of acute respiratory infections in children under five years of age. In conclusion, the contribution of wealth-related inequality to the child and maternal health service coverage gap differs by country and type of health service, warranting case-specific interventions. Targeted policies are most appropriate where high within-country wealth-related inequality exists, and whole-population approaches, where the health-service coverage gap is high in all quintiles.
Unsafe water bodies, poor access to safe drinking water, indoor and outdoor air pollution, unhygienic or unsafe food, poor sanitation, inadequate waste disposal, absent or unsafe vector control, and exposure to chemicals and injuries have been identified as key environmental risks to human health in most countries in Africa. The underlining reasons for this situation include inadequate or flawed policies, weak institutional capacities, shortage of resources and low general awareness of links between the environment and health. This paper suggests that governments re-orient their national policies to foster a greater contribution of environmental management towards public health. Specifically, governments may consider creating national frameworks and mechanisms for inter-sectoral action to adequately address the links between health and the environment, invest in the required infrastructure related to health and environmental services, build from past and current experiences, revitalise expertise in environmental management for health, and increase communication and community education to raise awareness of how individual practices can impact upon human health and the environment.
According to the World Health Organisation malnutrition is associated with about 60 percent of deaths in children under five years old in the developing world. The WHO has developed guidelines to improve the quality of hospital care for malnourished children in order to reduce deaths. The guidelines suggest ten steps for routine management of severe malnourishment. These will require most hospitals to make substantial changes. The London School of Hygiene and Tropical Medicine, together with the University of the Western Cape, and the Health Systems Trust, South Africa conducted a study in two hospitals - Mary Theresa and Sipetu - in rural Eastern Cape Province, South Africa. The study was designed to assess the extent to which the guidelines have been implemented and whether they have reduced fatality rates among children diagnosed with severe malnutrition.