The One Health concept covers the interrelationship between human, animal and environmental health and requires multi-stakeholder collaboration across many cultural, disciplinary, institutional and sectoral boundaries. Yet, the implementation of the One Health approach appears hampered by shortcomings in the global framework for health governance. Knowledge integration approaches, at all stages of policy development, could help to address these shortcomings. The identification of key objectives, the resolving of trade-offs and the creation of a common vision and a common direction can be supported by multi-criteria analyses. Evidence-based decision-making and transformation of observations into narratives detailing how situations emerge and might unfold in the future can be achieved by systems thinking. Finally, transdisciplinary approaches can be used both to improve the effectiveness of existing systems and to develop novel networks for collective action. To strengthen One Health governance, the authors propose that knowledge integration becomes a key feature of all stages in the development of related policies and suggest several ways in which such integration could be promoted.
Governance and participation in health
The incidence of prostate cancer in Uganda is one of the highest recorded in Africa. Prostate cancer is the most common cancer among men in Uganda. This study assessed the current knowledge, attitudes and practices of adult Ugandan men regarding prostate cancer through a descriptive cross-sectional study using interviewer administered questionnaires and focus group discussions among 545 adult men aged 18–71 years, residing in Kampala, the capital of Uganda. The majority of the respondents had heard about prostate cancer but 46% had not. The commonest source of information about prostate cancer was the mass media. Only 13% of the respondents obtained information about prostate cancer from a health worker. Respondents confused prostate cancer with gonorrhea and had various misconceptions about its causes. Only 10% of the respondents had good knowledge of the symptoms of prostate cancer.
The University of Oxford's Global Economic Governance Programme has launched an independent Expert Taskforce on Global Knowledge Governance to propose a set of principles and options for the future of global knowledge governance. The Taskforce's Honorary Advisors emphasised the scope of global knowledge governance challenges at hand. The Taskforce will be led by a small, core team of experts participating in a personal capacity, supported by several distinguished Honorary Advisors. The Taskforce will consult widely, interviewing a diversity of academics, policy experts, and stakeholder communities around the world. The report will be peer-reviewed by a group of leading international scholars working on the intersection of issues covered in the study. The findings of the Taskforce will be published in late 2010 and presented to governments, relevant international organisations, stakeholders and academics working to shape how the future of global knowledge governance unfolds.
This paper addresses the lack of monitoring and evaluation (M&E) procedures within HIV/AIDS programme design. It offers a practical guide to developing, monitoring and evaluating practice in HIV/AIDS-related programmes for young people, based on the experience of projects around the world. It focuses on recent learning from work with young people in peer education, school-based education, clinic-based service delivery reaching especially vulnerable children, and working with children affected by HIV/AIDS. Good examples of practice are included throughout.
Citizen-based accountability strategies to improve the lives of the poor and marginalised groups are increasingly being used in efforts to improve basic public services. The latest thinking suggests that broader, multi-pronged, multi-level, strategic approaches that may overcome the limitations of narrow, localised successes, hold more promise. This paper examines the challenges and opportunities, in theory and practice, posed by the integration of two such citizen-based accountability strategies—social accountability and legal empowerment. It traces the foundations of each of these approaches to highlight the potential benefits of integration. Consequently it examines whether these benefits have been realised in practice, by drawing upon five cases of organisations pursuing integration of social accountability and legal empowerment for health accountability in Macedonia, Guatemala, Uganda, and India. The cases highlight that while integration offers some promise in advancing the cause of social change, it also poses challenges for organisations in terms of strategies they pursue.
While bi- and multilateral communication and collaboration are the foundation for global control of infectious disease epidemics, they are strengthened by the International Health Regulations (IHR). Although IHR (2005) describes what must be achieved by countries, there is limited knowledge on how countries should proceed in achieving the core capacities. To fill this gap and accelerate implementation of IHR (2005), the World Health Assembly in 2015 identified a need to evaluate and share the lessons learnt from countries that have implemented IHR (2005). This systematic review was conducted in accordance with Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines, using a predefined protocol. The authors identified five global lessons learnt that related to multiple IHR (2005) core capacities. Some major cross-cutting themes included the need for mobilizing and sustaining political commitment; for adapting global requirements based on the local socio-cultural, epidemiological, health system and economic contexts; and for conducting baseline and follow-up assessments to monitor IHR (2005) status. The authors argue that despite considerable progress, countries that are yet to implement IHR (2005) core capacities may have insufficient human and financial resources to meet their obligations in the near future.
This book examines the context and social construction of sexuality, HIV prevention and community development, based on a three-year study of a large-scale HIV/AIDS prevention programme in a South African gold mining community. The Summertown Project was a well-resourced intervention that sought to promote sexual health through the treatment of STIs, community-led peer education, and the promotion of local participation and 'stakeholder' partnerships.
The global AIDS response has shown that at the core of health lie considerations of social justice, human rights, and accountability. As momentum builds for a Framework Convention on Global Health (FCGH), the authors of this paper argue that there is an opportunity to take stock of lessons learned from the response to HIV and AIDS and ensure that they are replicated and institutionalised in an eventual Convention. They further argue that the most critical aspect to the success of the HIV response has been the leadership and activism of civil society. Success requires active monitoring of progress and shortcomings, combined with political and social mobilisation to expand investment and access to the services and underlying conditions that protect and advance health. While the FCGH must make civil society support and engagement an indispensable principle, the AIDS movement can contribute substantive content and mobilisation for its adoption. A broad international legal framework for health can help address some of the key legal, policy, regulatory, and programmatic challenges that continue to hinder effective responses to HIV.
A study was conducted to explore the views of villagers on the existence and functioning of local primary health-care (PHC) committees, village health workers (VHWs), skilled staff at government health facilities and their responsiveness to community health needs in Mkuranga district, Tanzania. Information was collected through separate group discussions with some members of households, local PHC committees and district health managers and semistructured interviews with individual household members, clinical and nursing staff at peripheral government facilities, and indepth interviews with officers in central and local government departments at district level. See the full report.
The Synergy Project documents a successful model for facilitating a strong community response to HIV and AIDS. The model was used in the Salvation Army Change programme in the Ndola and Choma districts of Zambia. It aims to build on local strengths and resources which enable ordinary people to address barriers to using HIV and AIDS information and services. The basis of this approach is that the demand for and use of voluntary counselling and testing (VCT), prevention of mother-to-child transmission and antiretroviral therapy services will only increase by addressing risk, stigma and the potential for personal change.