The Shibboleth of Human Rights in Public Health

Human rights discourse has greatly influenced advocacy for justice in public health. Yet, beyond rhetorical claims, how can we employ human rights to achieve the aspiration of health with justice? Without human rights education to support public health practice, human rights have become a shibboleth of public health—raised frequently to signal devotion to justice, but employed rarely in policy, programming, or practice. As advocates respond to the public health injustices of populist nationalism during an unprecedented pandemic, human rights education must be an essential foundation to hold governments accountable for implementing rights to safeguard public health

The Shibboleth of Human Rights in Public Health

Human rights discourse has greatly influenced advocacy for justice in public health. Yet, beyond rhetorical claims, how can we employ human rights to achieve the aspiration of health with justice? Without human rights education to support public health practice, human rights have become a shibboleth of public health—raised frequently to signal devotion to justice, but employed rarely in policy, programming, or practice. As advocates respond to the public health injustices of populist nationalism during an unprecedented pandemic, human rights education must be an essential foundation to hold governments accountable for implementing rights to safeguard public health

Transitioning from donor aid for health: perspectives of national stakeholders in Ghana

Background Ghana’s shift from low-income to middle-income status will make it ineligible to receive concessional aid in the future. While transition may be a reflection of positive changes in a country, such as economic development or health progress, a loss of support from donor agencies could have negative impacts on health system performance and population health. We aimed to identify key challenges and opportunities that Ghana will face in dealing with aid transition, specifically from the point of view of country-level stakeholders.Methods We conducted key informant interviews with 18 stakeholders from the government, civil society organisations and donor agencies in Ghana using a semistructured interview guide. We performed directed content analysis of the interview transcripts to identify key themes related to anticipated challenges and opportunities that might result from donor transitions.Results Overall, stakeholders identified challenges more frequently than opportunities. All stakeholders interviewed believe that Ghana will face substantial challenges due to donor transitions. Challenges include difficulty filling financial gaps left by donors, the shifting of national priorities away from the health sector, lack of human resources for health, interrupted care for beneficiaries of donor-funded health programmes, neglect of vulnerable populations and loss of the accountability mechanisms that are linked with donor financing. However, stakeholders also identified key opportunities that transitions might present, including efficiency gains, increased self-determination and self-sufficiency, enhanced capacity to leverage domestic resources and improved revenue mobilisation.Conclusion Stakeholders in Ghana believe transitioning away from aid for health presents both challenges and opportunities. The challenges could be addressed by conducting a transition readiness assessment, identifying health sector priorities, developing a transition plan with a budget to continue critical health programmes and mobilising greater political commitment to health. The loss of aid could be turned into an opportunity to integrate vertical programmes into a more comprehensive health system

Development of a Blended Learning Approach to Delivering HIV-Assisted Contact Tracing in Malawi: Applied Theory and Formative Research

BackgroundDespite progress toward the Joint United Nations Programme on HIV/AIDS “95-95-95” targets (95% of HIV-positive persons tested, 95% of tested persons on treatment, and 95% of treated persons virally suppressed), a gap remains in achieving the first 95% target. Assisted contact tracing (ACT), in which health workers support HIV-positive index clients to recruit their contacts (sexual partners and children) for HIV testing, efficiently identifies HIV-positive persons in need of treatment. Although many countries, including Malawi, began implementing ACT, testing outcomes in routine settings have been worse than those in trial settings. ObjectiveThe aim of this paper is to use formative research and frameworks to develop and digitize an implementation package to bridge the gap between ACT research and practice. MethodsSemistructured qualitative research was conducted in 2019 in Malawi with key informants. Barriers and facilitators to intervention delivery were identified using the Consolidated Framework for Implementation Research. Approaches to digitization were examined using human-centered design principles. ResultsLimited clinic coordination and health worker capacity to address the complexities of ACT were identified as barriers. Ongoing individual training consisting of learning, observing, practicing, and receiving feedback, as well as group problem-solving were identified as facilitators. Important features of digitization included (1) culturally relevant visual content, (2) capability of offline use, and (3) simple designs and basic editing to keep costs low. ConclusionsFormative research and frameworks played a key role in designing and digitizing an implementation package for ACT delivery in a low-income setting such as Malawi