Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania.

In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term 'motivation' was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in professional ethics, and the way this is reinforced in practice require closer attention. The differences in the findings across the three settings underscore the importance of in-depth country-level research to tailor the development of incentives schemes

Grassroots Agency: Participation and Conflict in Buenos Aires Shantytowns seen through the Pilot Plan for Villa 7 (1971–1975)

open access articleIn 1971, after more than a decade of national and municipal policies aimed at the top-down removal of shantytowns, the Buenos Aires City Council approved the Plan Piloto para la Relocalización de Villa 7 (Pilot Plan for the Relocation of Shantytown 7; 1971–1975, referred to as the Pilot Plan hereinafter). This particular plan, which resulted in the construction of the housing complex, Barrio Justo Suárez, endures in the collective memory of Argentines as a landmark project regarding grassroots participation in state housing initiatives addressed at shantytowns. Emerging from a context of a housing shortage for the growing urban poor and intense popular mobilizations during the transition to democracy, the authors of the Pilot Plan sought to empower shantytown residents in novel ways by: 1) maintaining the shantytown’s location as opposed to eradication schemes that relocated the residents elsewhere, 2) formally employing some of the residents for the stage of construction, as opposed to “self-help” housing projects in which the residents contributed with unpaid labor, and 3) including them in the urban and architectural design of the of the new housing. This paper will examine the context in which the Pilot Plan was conceived of as a way of re-assessing the roles of the state, the user, and housing-related professionals, often seen as antagonistic. The paper argues that residents’ fair participation and state intervention in housing schemes are not necessarily incompatible, and can function in specific social and political contexts through multiactor proposals backed by a political will that prioritizes grassroots agency

Indigenous Peoples’ food systems, nutrition and gender:Conceptual and methodological considerations

Indigenous Peoples, especially women and children, are affected disproportionately by malnutrition and diet-related health problems. Addressing this requires an investigation of the structural conditions that underlie unequal access to resources and loss of traditional lifestyles, and necessitates inclusive approaches that shed light onto these issues and provide strategies to leverage change. Indigenous Peoples’ food systems are inextricably connected to land, which in turn is interwoven with issues of self-determination, livelihoods, health, cultural and spiritual heritage, and gender. Ongoing loss of land and the dominant agri-food model further threaten Indigenous Peoples’ food systems. Continuing gender-based discrimination undermines the self-determination and rights of women, and negatively impacts on their health, nutritional status, and overall wellbeing, as well as on the wellbeing of households and communities. We suggest that feminist political ecology and modern matriarchal studies provide holistic interlinking frameworks for investigating underlying issues of power and inequality. We further argue that a focus on the principles of respect, responsibility, and relationships, and an openness to different worldviews, can facilitate a bridging of Indigenous and Western approaches in research and community action conducted in partnership with Indigenous Peoples. This can contribute to creating new ways of knowing regarding Indigenous Peoples’ food systems, equally valuing both knowledge systems. Indigenous Peoples’ rights, right to food, and food sovereignty are frames that, despite some tensions, have the common goal of self-determination. Through their ability to inform, empower, and mobilize, they provide tools for social movements and communities to challenge existing structural inequalities and leverage social change. Publisher Statement: This is the peer reviewed version of the following article: Lemke, S & Delormier, T 2018, 'Indigenous Peoples’ food systems, nutrition and gender: Conceptual and methodological considerations' Maternal & Child Nutrition, vol 13, no. S3, e12499, which has been published in final form at https://dx.doi.org/10.1111/mcn.12499. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving

Water quality and its interlinkages with the Sustainable Development Goals

Interlinkages among the Sustainable Development Goals (SDGs) lead to important trade-offs and synergies among the goals and their underlying targets. The aim of this paper is to review the role of water quality as an agent of interlinkages among the SDGs. It was found that there are a small number of explicit interconnections, but many more inferred interlinkages between water quality and various targets. A review of case studies showed that interlinkages operate from the municipal to near global scales, that their importance is likely to increase in developing countries, and that new SDG indicators are needed to monitor them. The analysis identifies many different SDG target areas where a combined effort between the water quality community and other sectors would bring mutual benefits in achieving the water quality and other targets

Report on the situation of human rights in Rwanda submitted by Mr. René Degni-Ségui, special rapporteur of the commission on human rights, under paragraph 20 of resolution S-3/1 of 25 May 1994

Document collected by the University of Texas Libraries from the web-site of the Reseau Documentaire International Sur La Region Des Grands Lacs Africains (International Documentation Network on the Great African Lakes Region). The Reseau distributes "gray literature", non-published or limited distribution government or NGO documents regarding the Great Lakes area of central Africa including Rwanda, Burundi, and the Democratic Republic of Congo.UT Librarie

The impact of poor health on factor productivity: an empirical investigation

A number of recent studies have illustrated the link between health and economic growth. This paper argues that a key mechanism through which health affects growth is via total factor productivity (TFP). We first estimate TFP based on a production function and then estimate the determinants of TFP, paying particular attention to three indicators of health that are particularly problematic in developing regions: malnutrition, malaria and water borne diseases. We find the impact of poor health on TFP to be negative, significant, and robust across a wide variety of specifications

Death penalty: the political foundations of the global trend toward abolition

The death penalty is like no other punishment. Its continued existence in many countries of the world creates political tensions within these countries and between governments of retentionist and abolitionist countries. After the Second World War, more and more countries have abolished the death penalty. This article argues that the major determinants of this global trend toward abolition are political, a claim which receives support in a quantitative cross-national analysis from 1950 to 2002. Democracy, democratization, international political pressure on retentionist countries and peer group effects in relatively abolitionist regions all raise the likelihood of abolition. There is also a partisan effect as abolition becomes more likely if the chief executive’s party is left-wing oriented. Cultural, social and economic determinants receive only limited support. The global trend toward abolition will go on if democracy continues to spread around the world and abolitionist countries stand by their commitment to press for abolition all over the world.

UN Security Council Briefing on the Situation in Haiti

This briefing provides a statement on behalf of the ECOSOC Ad Hoc Advisory Group on Haiti and the devastating impacts that the kidnappings and clear violations of human rights have had on the people of Haiti