Following the 11 September 2001 terrorist attacks, the United States (US) military expanded its global health engagement as part of broader efforts to stabilise fragile states, formally designating “medical stability operations” as use of Department of Defense (DoD) medical assets to build or sustain indigenous health sector capacity. Medical stability operations have included medical assistance missions launched by US Africa Command throughout Africa. The public health impact of such initiatives, and their effectiveness in promoting stability is unclear, the author notes. Moreover, humanitarian actors have expressed concern about military encroachment on the “humanitarian space,” potentially endangering aid workers and populations in need, and violating core principles of humanitarian assistance. The DoD should draw on existing data to determine whether, and under what conditions, health engagement promotes stability overseas and develop a shared understanding with humanitarian actors of core principles to guide its global health engagement.
Governance and participation in health
In this study, researchers investigated use and understanding of nutrition labels on food packages among urban and rural consumers in Lilongwe, Malawi. They also examined the effect of socio-demographic factors and nutrition knowledge on use of nutrition labels. The researchers surveyed 206 consumers, approached randomly after they checked out at grocery stores. Shop managers and owners gave their consent to conduct the study outside the shops to avoid affecting customer behaviour and revenues. A pre-tested questionnaire was used to collect data for analysis and interpretation. The findings show that self-reported use and understanding of nutrition labels were low, suggesting much lower use and comprehension in real-life retail environments. Urban, educated and female consumers were more likely to read nutrition panels when purchasing food. Nutrition labels were seen as important, particularly when purchasing a product for the first time and when considering buying certain products. In terms of nutrition knowledge, rural consumers were as knowledgeable as urban consumers, but they were less likely to connect their knowledge to emerging non-communicable diseases. The researchers caution that the study had some limitations: for example, they surveyed a small sample of shoppers drawn from one geographical area, therefore their findings are not conclusive. Objective, cross-sectional and longitudinal investigations in future would improve understanding of actual consumer behaviour in retail shops and homes in Malawi, the researchers argue. As this study is the first of its kind in Malawi, it is intended to provide baseline information useful to the healthcare professionals, the government, the food industry and consumers.
In this article, the author examines the potential role of health information technology (IT) in addressing healthcare disparities among racial and ethnic minority populations. The author’s overview of health IT utilisation among healthcare providers reveals that use of health IT among racial and ethnic minorities carries significant promise and potential. Yet realising the potential will not come without surmounting several significant technical, practical and human challenges. In order to measure success or failure, he argues for ongoing surveillance and monitoring of progress at a national level. However, because of the great diversity in the types of technologies, types of users, and settings in which health IT may be employed, obtaining accurate estimates of adoption and utilisation will be a significant challenge. In addition, the development of the ‘meaningful use’ criteria and the linking of meaningful use to provider reimbursement will help, the author adds. As patients become more involved in accessing, managing, and using their health information, a need to develop ‘meaningful patient use’ criteria may arise, he predicts, which will help refine systems.
This paper provides perspectives from a three-year intervention whose general objective was to develop and test models of good practice for health committees in South Africa and Uganda. It describes the aspects that the authors found critical for enhancing the potential of such committees in driving community participation as a social determinant of the right to health. Interventions in South Africa and Uganda indicate that community participation is not only a human right in itself but an essential social determinant of the right to health. The interventions show that health committees provide a mechanism that enables communities to be active and informed participants in the creation of a responsive health system that serves them efficiently. The results are argued to confirm the effectiveness of rights-based trainings and exchanges in strengthening committee members’ sense of agency, their capacity to engage the health system, and their ability to exercise claims to health rights. They also contribute evidence of health committees’ potential to play a critical role in advancing community participation as a social determinant of the right to health.
These participatory spaces are observed to bridge the gap between communities and health facilities, making services responsive to community needs and contributing to the realization of health as a human right.
UN-Habitat believes that ICT can be a catalyst to improve governance in towns and cities and help increase levels of participation, efficiency and accountability in public urban policies, provided that the tools are appropriately used, accessible, inclusive and affordable. Research shows that ICT use by youth can have a direct impact on increasing civic engagement, giving them new avenues through which to become informed, shape opinions, get organised, collaborate and take action. Youth are at the centre of the ICT revolution, both as drivers and consumers of technological innovation. They are almost twice as networked as the global population as a whole, with the ICT age gap more pronounced in least developed countries where young people are up to three times more likely to be online than the general population. This video shows UN-Habitat’s approach to using Minecraft to encourage youth participation in urban design and governance, to design and present their vision for public spaces in the city, as an input to planning. UN-Habitat’s experiences of using the video game Minecraft as a community participation tool for public space design is reported to show that providing youth with ICT tools can promote improved civic engagement.
Organizations that collect substantial data for decision-making purposes are often characterised as being data rich but information poor. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for non-specialists to use such tools. This on-going project has two primary phases. This paper critically reflects on phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool.
A Cape Town doctor has dramatically helped the fight against tuberculosis (TB) by introducing a SMS service to remind patients to take their medication. Dr. David Green, a consultant in Managed Care, Disease Management and Information Systems, became so frustrated when his mother constantly forgot to take her medication for hypertension, that he started sending her SMS reminders -- and it worked. It did not take him long to make the connection between the effectiveness that his SMS messages had on alerting his mother, the high incidence of TB in Cape Town, and the possibilities that bulk SMS messages could present.
The aim of this paper is to support all stakeholders who are developing or researching universal health care (UHC) reforms and who wish to conduct stakeholder analysis to support evidence-informed pro-poor health policy development. It presents practical lessons and ideas drawn from experience conducting stakeholder analysis around UHC reforms in South Africa and Tanzania, revealing that differences in context and in reform proposals generate differences in the particular interests of stakeholders and their likely positioning on reform proposals, as well as in their relative balance of power. It is, therefore, difficult to draw cross-national policy comparisons around these specific issues, the authors caution. Nonetheless, they argue that cross-national policy learning is possible with regard to choosing approaches to policy analysis and management of policy processes, but stakeholders should avoid generalisations when comparing UHC reform packages and should rather focus on how to manage the reform process within a particular context. The authors emphasise that stakeholder analyses can be used both to think through the political viability of new policy proposals and to develop broader political management strategies to support policy change.
The Learning Network for Health and Human Rights is a network is a collection of 5 civil society organisations (The Women's Circle, Ikamva Labantu, Epilepsy South Africa, The Women on Farms Project and the Cape Metro Health Forum) as well as 4 higher education institutions (UCT, UWC, Maastricht University, in the Netherlands, and Warwick University in the UK). The network collaborates to explore how collective action and reflection can identify best practice with regard to using human rights to advance health issues. The work of the Learning Network seeks to operationalise the right to health as stated in South Africa’s Constitution and other international treaties and agreements. This is accomplished through a programme in which research, training and advocacy are linked to empower organisations and their members to assert rights for health. One of their latest training materials, this video explores the role of Health Committees from different perspectives – from that of a facility manager, a health care provider, health committee members and patients. It aims to enhance understanding of what Health Committees can do, what the challenges are in building effective health committees and how they can strengthen the health system.
Deepa Narayan, Robert Chambers, Meera K. Shah and Patti Petesch - 2001
This book is based on the realities of poor people. It draws upon research conducted in 1999 involving 20,000 poor women and men from 23 countries. Despite very different political, social and economic contexts, there are striking similarities in poor people's experiences. The common theme underlying poor people's experiences is one of powerlessness. Powerlessness consists of multiple and interlocking dimensions of illbeing or poverty. The organisation of this book roughly follows the 10 dimensions of powerlessness and illbeing that emerge from the study. The remainder of the book presents methodology and the challenges faced in conducting the study.