The author questions whether Uganda national referral hospitals are performing their function. The author asks why a section of persons should be given special treatment by government in the names of being ‘Very Important Persons’ to access the best medical services in referral facilities for first line care or in ‘uptown’ private medical facilities and abroad. The author proposes that government perform its core minimum obligation and ensure that its public health care facilities function effectively.
Equitable health services
When a national referral hospital ceases to be one: Reminding government of its duties
Job K: Center for Health, Human Rights and Development (CEHURD), 2019
When did medicines become essential?
Greene JA: Bulletin of the World Health Organization 88: 483–484, July 2010
According to this article, placing essential medicines at the centre of global health priorities is not without its risks. The geography of access is closely linked to other structural determinants of inequality, few of which can be fixed merely by providing a pipeline of medicines. Access to essential medicines is therefore a necessary condition but is not sufficient on its own for the amelioration of broad health disparities in global health. On the other hand, to truly engage the social factors that determine the development, production, regulation, distribution, utilisation and consumption of essential medicines is to engage with the project of understanding health disparities and the challenges of strengthening health systems at the most detailed level. As essential medicines programmes continue to expand, this article argues that it is crucial that they have the resources and leadership to realise this vision in the broadest sense possible.
Where Do the Rural Poor Deliver When High Coverage of Health Facility Delivery Is Achieved? Findings from a Community and Hospital Survey in Tanzania
Straneo M, Fogliati P, Azzimonti G, Mangi S, Kisika F: PLoS ONE 9(12), December 2014
As part of maternal mortality reducing strategies, coverage of delivery care among sub-Saharan African rural poor will improve, with a range of facilities providing services. Whether high coverage will benefit all socio-economic groups is unknown. Iringa rural District, Southern Tanzania, with high facility delivery coverage, offers a place to address this question. Delivery services are available in first-line facilities (dispensaries, health centres) and one hospital. The authors assessed whether all socio-economic groups access the only comprehensive emergency obstetric care facility equally, and surveyed existing delivery services. Hospital population socio-demographic characteristics were compared to District population using multivariable logistic regression. Women from the hospital compared to the district population were more likely to be wealthier. Poorer women remain disadvantaged even where coverage is high, as they access lower level facilities and are under-represented where life-saving transfusions and caesarean sections are available.
Where have all the mosquito nets gone? Spatial modelling reveals mosquito net distributions across Tanzania do not target optimal Anopheles mosquito habitats
Acheson E; Plowright A; Kerr J: Malaria Journal 14(322) 2015
The United Republic of Tanzania has implemented countrywide anti-malarial interventions over more than a decade, including national insecticide-treated net (ITN) rollouts and subsequent monitoring. While previous analyses have compared spatial variation in malaria endemicity with ITN distributions, no study has yet compared Anopheles habitat suitability to determine proper allocation of ITNs. This study assesses where mosquitoes were most likely to thrive before implementation of large-scale ITN interventions in Tanzania and determine if ITN distributions successfully targeted those areas. The spatial distribution of ITN ownership across Tanzania was near-random spatially. Mosquito habitat suitability was statistically unrelated to reported ITN ownership and very weakly to the proportion of households with ≥1 ITN. ITN ownership declined significantly toward areas with the highest vector habitat suitability among households with lowest ITN ownership. In areas with lowest habitat suitability, ITN ownership was consistently higher. Insecticide-treated net ownership is critical for malaria control. While Tanzania-wide efforts to distribute ITNs has reduced malaria impacts, gaps and variance in ITN ownership are unexpectedly large in areas where malaria risk is highest. Supplemental ITN distributions targeting prime Anopheles habitats are likely to have disproportionate human health benefits.
WHO and UNICEF tackle problem of lack of essential medicines for children
World Health Organisation, 14 August 2006
The first "International Expert Consultation on Paediatric Essential Medicines", jointly held by the World Health Organization (WHO) and the United Nation’s Children’s Fund (UNICEF), has delivered a plan to boost access to essential medicines for children. During two days of intensive discussion held 9-10 August at WHO's headquarters in Geneva, a mix of more than twenty developed and developing countries, non-governmental organizations including Médecins Sans Frontières, regulatory agencies, UNICEF and WHO staff prioritised a long-needed approach to overall paediatric care.
Who benefits from health care in South Africa?
Health Economics Unit, University of Cape Town: Information sheet 5, 2010
According to this information sheet, within the public sector, the poor benefit relatively more than the rich from outpatient services at lower levels of care (i.e., district hospitals, clinics and community health centres). The rich benefit considerably more than the poor from regional and central hospital services (both outpatient and inpatient services) and also benefit more from public sector inpatient services overall. The rich benefit far more from private sector services than the poor; the richest 40% of the population receive about 70% of the benefits of private outpatient services (from general practitioners, specialists, dentists and retail pharmacies) and nearly 80% of the benefits of inpatient care in private hospitals. Overall, health care benefits in South Africa are very ‘pro-rich’, with the richest 20% of the population receiving more than a third of total benefits while the poorest 20% receive less than 13% of the benefits, despite the poor bearing a much greater share of the burden of ill-health than the rich.
WHO Guidelines for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and other Influenza Viruses
World Health Organization: 20 August 2009
This document provides advice to clinicians on the use of the currently available antivirals for patients presenting with illness due to influenza virus infection as well the potential use of the medicines for chemoprophylaxis. While the focus is on management of patients with pandemic influenza (H1N1) 2009 virus infection, the document includes guidance on the use of the antivirals for other seasonal influenza virus strains, and for infections due to novel influenza. WHO recommends that country and local public health authorities issue local guidance for clinicians from time to time that places these recommendations in the context of epidemiological and antiviral susceptibility data on the locally circulating influenza strains. It emphasises that healthy people, namely those without chronic or acute diseases, do not need the antivirals.
WHO members slow to bridge disagreements at pandemic flu meeting
Mara K: Intellectual Property Watch, 11 December 2008
Four days into one-week 'critical' negotiations on pandemic influenza preparedness, World Health Organization members had yet to tackle areas of core disagreement and participants were expressing doubt as to whether consensus can be achieved before the end of the meeting. Details on the definition of 'Pandemic Influenza Preparedness (PIP) Biological Materials', on the content of a standard material transfer agreement for virus sharing and on the interconnection between a mechanism for virus-sharing and a mechanism for sharing of benefits from vaccine development have yet to be discussed or have been pushed until later in the meeting for more substantive discussion and hoped-for consensus. These interrelated topics represent core differences between member states and thus are likely to be most difficult to resolve at the WHO Pandemic Influenza Preparedness Intergovernmental Meeting.
WHO releases new guidance on insecticide-treated mosquito nets
World Health Organisation, 16 August 2007
The World Health Organization (WHO) today issued new global guidance for the use of insecticide-treated mosquito nets to protect people from malaria. For the first time, WHO recommends that insecticidal nets be long-lasting, and distributed either free or highly subsidized and used by all community members. Impressive results in Kenya, achieved by means of the new WHO-recommended strategy, show that free mass distribution of long-lasting insecticidal nets is a powerful way to quickly and dramatically increase coverage, particularly among the poorest people. This is the first demonstration of the impact of large-scale distribution of insecticide treated mosquito nets under programme conditions, rather than in research settings, where, in different parts of Africa, reduction observed in overall mortality has ranged from 14 % up to 60 %.
WHO supports fair access to influenza A (H1N1) vaccine
Kieny M: Bulletin of the World Health Organization 87(9): no page no’s, September 2009
Some manufacturers announced in July that the H1N1 vaccine is available, but that doesn’t mean it’s ready for use, as it needs regulatory approval. Regulatory authorities are considering the best way to register these vaccines as quickly as possible. The consensus is that the first doses will be available to governments for use in September. The World Health Organization (WHO) has a cross-organisational operation that is in place to secure vaccines for developing countries, spearheaded by the Director-General’s Office and the legal and vaccine departments. WHO is engaged in three types of activities. The first is to negotiate donations with manufacturers. Second, it is working with other manufacturers to reserve a portion of their vaccine production for WHO at a reduced price. Third, it is working with governments to raise funds to purchase vaccines, as well as with 11 vaccine manufacturers based in developing countries, providing them with seed financing and technical expertise to help them produce influenza vaccine domestically.