I'm apprehensive- what can I, an academic, write about the World Social Forum (WSF) January 2007? This WSF in Nairobi was the first I had attended. I was invited by the Eastern Africa Coalition on Economic social and cultural rights under the Human rights caucus to discuss how evidence from research supports civil society efforts. I met several groups of people from all walks of life, and from all over the world – farmers, people living in slums, refugees, gay people, those fighting for the rights of the poor, and others. After my talk, a Civil Society Organization (CSO) leader came to me and said: “Mugisha, thank for your talk. We in civil society have the guns, but we lack bullets”. For a moment, I did not understand. Was he talking about a guerilla war? Later I understood him to mean that civil society have the platform, but lack the evidence to inform and sharpen their messages for maximum impact.
Equity in Health
Compared with some countries in sub-Saharan Africa, infant mortality rate is relatively high in Tanzania, at 68 per 1000 live births (2004-2005). Studies of factors affecting infant mortality have rarely considered the role of birth order. This study aims to contribute to fill this research gap by determining the risk factors associated with infant mortality in Ifakara in rural Tanzania from January 2005 to December 2007. Data for 8,916 live births born from 1 January 2005 to 31 December 2007 was extracted for analysis. The study found that first and higher birth orders had highest levels of infant death, while mothers younger than 20 years old had the highest infant mortality. From 2005–2007, malaria remained the leading cause of infant death. Giving birth at the hospital was perceived by women to be associated with severe delivery complications. The study recommends that Tanzania’s health systems urgently need strengthening, and efforts should be made to communicate the benefits of health facility deliveries more effectively. Voluntary and community health workers also need to be trained adequately to recognise factors that put infants at risk.
The persistence of health inequities provides an ongoing challenge for health promotion. The dictum 'think globally, act locally' fails to recognise the significance of infrastructure and policy in linking global issues and local practices as a means of addressing health inequities. This article is in the form of a commentary and opinion, and final comments include that Health promotion needs to beg, borrow and build political and media advocacy skills if it is to go beyond local demonstration projects and have the capacity to promote population health and address health inequities.
Despite the establishment of a 'health inequities knowledge base', the precise roles for municipal governments in reducing health inequities at the local level remain poorly defined. The objective of this study was to monitor thematic trends in this knowledge base over time, and to track scholarly prescriptions for municipal government intervention on local health inequities. Of the total of 1,004 journal abstracts pertaining to health inequities that were analysed, the overall quantity of abstracts increased considerably over the 20 year timeframe. 'Healthy lifestyles' and 'healthcare' were the most commonly emphasised themes, but only 17% of the abstracts articulated prescriptions for municipal government interventions on local health inequities. This study has demonstrated a pervasiveness of 'behavioural' and 'biomedical' perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community. Thus, despite considerable research activity over the past two decades, the 'health inequities knowledge base' inadequately reflects the complex aetiology of, and solutions to, population health inequities.
Twenty-six years after the formation of the Southern Africa Development Community (SADC), it is estimated that 80% of the people in the region are living below the poverty datum line. What is the level of commitment within SADC towards improving the people’s livelihoods? Is SADC a true representation of African solidarity? Has SADC pursued a neoliberal agenda to the cost of people's wellbeing? As the SADC heads of State met on 14 to 18 August 2006, in Maseru, Lesotho the poor peoples of the region gathered at the Cooperative College in Maseru in order to seek answers to the above questions; as well as to examine the impact of privatisation, market reforms and debt on peoples access to health services, education and other social amenities.
This report estimates consistent and coherent cause-specific death rates for the period 1997–2012 and identifies the leading causes of death and premature mortality for South Africa, taking into consideration and adjusting for the data deficiencies. The report used the methodology of the Global Burden of Disease Study 2005 in secondary analysis of data obtained from Statistics South Africa (Stats SA), the Injury Mortality Survey 2009 (IMS) and National Injury Surveillance System 2000 (NIMSS). For the non-communicable diseases, there was an increasing trend in numbers over the whole period while the trends for communicable disease combined with maternal causes, perinatal conditions and nutritional deficiencies, remained fairly stable between 1997 and 2009, decreasing slightly thereafter. HIV/AIDS and TB increased between 1997 and 2006, where it peaked at 687 deaths per 100,000 population and then decreased steadily each subsequent year. The report points to a considerable burden from non-communicable diseases and concerning signs of an increase in diabetes mortality. The authors say that efforts targeting prevention and management of non-communicable diseases and their risk factors need to be scaled up.
As pandemic (H1N1) influenza spreads around the globe, it strikes school-age children more often than adults. Although there is some evidence of pre-existing immunity among older adults, this alone may not explain the significant gap in age-specific infection rates. Based on a retrospective analysis of pandemic strains of influenza from the last century, this study shows that school-age children typically experience the highest attack rates in primarily naive populations, with the burden shifting to adults during the subsequent season. Using a parsimonious network-based mathematical model, which incorporates the changing distribution of contacts in the susceptible population, it demonstrates that new pandemic strains of influenza are expected to shift the epidemiological landscape in exactly this way. The analysis here provides a simple demographic explanation for the age bias observed for H1N1/09 attack rates, and suggests that this bias may shift in the future. These results have significant implications for the allocation of public health resources for H1N1/09 and future influenza pandemics.
The author describes a personal experience in the days of preparation for the World Social Forum 2007. After spending a few days in the company of young people like me from Kenya, Zambia, Zimbabwe and many other African Countries, I discovered that same early spirit of my community. To me the WSF is beginning to be and will be a deeply emotional experience. It’s emotional because we have been working very hard to make this day happen.
A detailed analysis of HIV-1 epidemiology in sub-Saharan Africa traces the spread of the virus to four factors: the subordinate position of women, poverty and the breakdown of social services, rapid urbanization, and war.
The African continent is currently in the midst of simultaneously unfolding and highly significant demographic, economic, technological, environmental, urban and socio-political transitions. Africa’s economic performance is promising, with booming cities supporting growing middle classes and creating sizable consumer markets. But despite significant overall growth, not all of Africa performs well. The continent continues to suffer under very rapid urban growth accompanied by massive urban poverty and many other social problems. These seem to indicate that the development trajectories followed by African nations since post-independence may not be able to deliver on the aspirations of broad based human development and prosperity for all. This report, therefore, argues for a bold re-imagining of prevailing models in order to steer the ongoing transitions towards greater sustainability based on a thorough review of all available options. That is especially the case since the already daunting urban challenges in Africa are now being exacerbated by the new vulnerabilities and threats associated with climate and environmental change.