Half of Africa's population, mostly the poor and disadvantaged, do not have access to existing essential medicines and many more are denied new medicines for treating common diseases like malaria and HIV, says a report released last Monday. "Only 50 000 of the 4.5-million people who need antiretroviral therapy have access to treatment despite significant reductions in cost," states the annual report for 2002 of the regional director of the World Health Organisation.
Equity in Health
Harare central hospital in need of care
Lack of finance has left the Harare Central hospital, one of Zimbabwe's major referral centres, on the verge of collapse. The superintendent of the 1,428-bed hospital, Chris Tapfumaneyi, told IRIN, "Most of our machines are obsolete and cannot be repaired - some of them have been like this for the past 10 years".
Harmonisation for Health in Africa: An action framework
World Health Organisation, 2007
This paper sets out an initiative by African Development Bank, UNAIDS, UNFPA, UNICEF, WHO and the World Bank that aims to tackle barriers to scaling up health in Africa. The ‘Harmonisation for Health in Africa’ initiative HHA is a regional mechanism through which collaborating partners agree to focus on providing support to the countries in the African region for reaching health MDGs. The HHA initiative aims to: support countries to identify, plan and address health systems constraints to improve health related outcomes; develop national capacity through training, planning, costing and budgeting, harmonisation and stimulating peer exchange; promote the generation and dissemination of knowledge, guidance and tools for specific technical areas including strengthening health service delivery and monitoring health systems performance; support countries to leverage predictable and sustained resources for the health sector; ensure accountability and assist in monitoring performance, of national health systems, aid effectiveness and the performance of the International Health Partnership; and enhance coordination to support nationally owned plans and implementation process, helping countries to address the country level bottlenecks arising from constraints within international agencies.
Head of WHO to stand down
Dr Gro Harlem Brundtland is to stand down as director general of the World Health Organization (WHO) in July 2003, after only one term. This will be the first time that a WHO director general has not been in office for at least two consecutive terms. In an interview with the BMJ immediately after the announcement, she said that her decision reflected the fact that she would be 69 at the end of a second term. "I don't want to get into a situation in my life where I'm not fully energetic and able to do my job," she said.
Heads, tails or equality? Men, women and reproductive health in Zambia
Centre for African Family Studies
This report is on male participation in sexual and reproductive health (SRH) examined within a wider context of gender relations and the family. It is the result of two collaborative surveys, one quantitative and one qualitative, which were conducted in rural and urban areas of the Copperbelt Province in Zambia. During the quantitative survey data was collected from men and their partners. The qualitative survey collected data through focus group discussions, in-depth interviews and two small community workshops.
Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)
Harvard T.H. Chan School of Public Health, University of Witwatersrand, Johannesburg, and the INDEPTH Network: 2019
The Health and Aging Study in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) is led by an interdisciplinary team of collaborators from Harvard School of Public Health, University of Witwatersrand, Johannesburg, and the INDEPTH Network, a global network of health and demographic surveillance systems based in Ghana. By integrating the HAALSI data with cause of death data from the INDEPTH Health and Demographic Surveillance System (HDSS) data at the MRC/Wits Agincourt research site, the authors explored the interrelationships between physical and cognitive functioning, lifestyle risk factors, household income and expenditure, depression and mental health, social networks and family composition, HIV infection and cardio-metabolic disease. In South Africa, the research found that people who were participating in the national HIV treatment programme were more likely to receive care for high blood pressure and achieve control of both blood pressure and blood sugar. This finding suggests that strong primary care systems are an important part of the answer to the disease trends of older adults and that South Africa’s national HIV treatment programme may offer a great platform for expanding primary care for all South Africans. Good health habits formed in childhood and in young adulthood – including avoiding smoking and alcohol overuse, engaging in physical activity and eating a nutritious diet are identified as being crucial to healthy ageing of the society of a whole.
Health and development: Global update: October 2010
HLSP Institute: October 2010
The HLSP Institute’s Global Update is a reference guide to the key events and activities of six months – April to September 2010 – in the health and development arena, with particular focus on aid effectiveness, health systems and public health. It reports on the United Nations (UN) Children’s Fund’s proposal to take a more equity-based approach to child health. The intended strategies are: upgrading selected facilities, particularly for maternal and newborn care, and expanding maternity services at the primary level, including maternity ‘waiting homes’; tackling the multiple barriers to access by the poorest – from massively expanding outreach services, and eliminating user charges, to extending cash transfers to cover indirect costs (e.g. transport); and task shifting, with more community outreach and involvement, and making greater use of community health workers to deliver basic health care services outside facilities. In terms of the global AIDS response, the update notes that the global AIDS response is at a crossroads, with a shortfall on achieving universal access targets, together with signs of funding declines and shortfalls. There has been growing attention to maternal health and commitments made in the US Global Health Initiative, the G8, the African Union Summit in Kampala in July 2010 and the MDG Summit in September 2010, with significant resources allocated to this area. The authors argue that assessing progress on delivery on these commitments and the impact of the resources is limited by lack of reliable and accurate maternal mortality data.
Health and Health Care in South Africa
Van Rensburg HCJ (Ed): Van Schaik Publishers, 2012
The changes that have taken place, and continue to take place, in South Africa’s post-1994 health sphere are often difficult to comprehend for both those inside and outside the country’s health care system. This book presents a coherent “big picture” of health and health care in South Africa. The contributing authors chart the evolving health system, along with the ensuing changes and challenges, and contextualise these developments historically and globally, as well as critically assess them. Contents include the following: national health care systems: trends, changes and reforms; the changing biophysical environment: impact on health and health conditions; HIV, AIDS and tuberculosis: trends, challenges and responses; health care expenditure: using resources efficiently and equitably; revitalisation and re-engineering of primary health care; hospitals and hospital reform; complementary and alternative medicine and traditional health care; and medical ethics and human rights. The book is aimed at researchers and lecturers, as well as senior and postgraduate students in the health and health-related professions, the social sciences, and health planning, policy and management-related disciplines.
Health and social justice
Ruger JP: Oxford University Press, 2010
Societies make decisions and take actions that profoundly impact the distribution of health. Why and how should collective choices be made, and policies implemented, to address health inequalities under conditions of resource scarcity? How should societies conceptualise and measure health disparities, and determine whether they've been adequately addressed? Who is responsible for various aspects of this important social problem? In her book, Jennifer Prah Ruger elucidates principles to guide these decisions, the evidence that should inform them, and the policies necessary to build equitable and efficient health systems world-wide. This book weaves together original insights and disparate constructs to produce a foundational new theory, the health capability paradigm, in which all people should have access to the means to avoid premature death and preventable morbidity. Ruger's theory takes the ongoing debates about the theoretical underpinnings of national health disparities and systems in a new rights-based direction. She shows the limitations of existing approaches (utilitarian, libertarian, Rawlsian, communitarian), and effectively balances a consequentialist focus on health outcomes and costs with a proceduralist respect for individuals' health agency. Through what Ruger calls ‘shared health governance’, her approach emphasises responsibility and choice. It allows broader assessment of injustices, including attributes and conditions affecting individuals' ability to ‘flourish’, as well as societal structures within which resource distribution occurs.
Health and the Commission for Africa report
Improving health in Africa must be acknowledged as essential both for the continent's attainment of the MDGs and for effective development strategies both regional and national, says this article in The Lancet, which reviews the Commission for Africa report in the light of Africa's complex health crisis. "We must hope that the report can deliver so that the Commission and the UK Government do not perpetuate the "fatal indifference" to Africa's complex health and development needs that has for too long characterised the policies of many developed nations."