Cost-effectiveness analysis for priority-setting in South Africa - what are the possibilities?

Priority-setting in the health system is necessary because resources are constrained. The role of cost-effectiveness analysis in supporting decision-making around health care priorities in South Africa is explored by referring to South African studies that have provided clinical and policy guidance at the levels of the patient, the service and the population. Cost-effectiveness evidence is positioned in relation to other concerns such as equity and the overall performance of the health system

Gravity

Thesis (M.S.V.S.)--Massachusetts Institute of Technology, Dept. of Architecture, 1985.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH.Transferred to 1/2 in VHS videotape from 8 mm film.Includes bibliographical references (leaves 56-57).Film is composed of tiny photographs which, when projected, sometimes look very much like people and things in the real world. Film, too, cannot be separated from its tools. Aesthetic criticism was, and still is, weighted towards consideration of the life-like tiny photographs. This thesis traces the evolution of film technology in order to establish the point where non- fiction ideology (aesthetics) lost pace with technical innovation - a derailment, so to speak, with nefarious implications for the present-day filmmaker. The emphasis is on lenses - the provocative "camera eye" - and sound recording equipment - which proved to be the rate-limiter of technical advance. This thesis considers two filmmaking solutions to the present malaise; the Standard TV Documentary, and the single-person shooting methodology of former MIT filmmakers, Jeff Kreines and Joel DeMott - both of which, in turn , will be compared to my own response - in the form of a movie, Gravity, which is about the members of an MIT experimental astrophysics laboratory trying to discover gravity waves. A videotape copy of the movie. is included with the thesis paper.by Mary Jane Doherty.M.S.V.S

Raising domestic resources for health Can tax revenue help fund Universal Health Coverage?

For countries that aspire to achieve the goal of Universal Health Coverage, the question of how to increase funding for health is of fundamental importance; external sources such as donor funding can be unstable and unsustainable, and insurance schemes often exclude the most poor and marginalised populations. Ensuring ‘health for all’ requires substantial increases in funding from domestic sources in a sustainable and equitable manner. One way of increasing revenue is through improved tax collection and larger total government budgets. Recent evidence from South Africa, Kenya and Lagos State in Nigeria, shows that it is possible to increase tax revenue without raising tax rates. What has been more challenging however, is ensuring that this additional revenue is allocated to the health sector. This brief outlines how the countries increased tax revenue and identifies common factors across contexts. It then uses the South African experience to explore whether the health sector benefited from additional tax revenue. The brief concludes with recommendations for health sector officials about how to negotiate more successfully for additional resources to be spent on health

Workplace-based learning for health system leaders: practical strategies for training institutions and governments

RESYST members Jane Doherty and Lucy Gilson have published a report following a three-day consultative workshop in Cape Town. The workshop brought together 35 leadership training experts from a range of institutions to enhance the capacity and capabilities of the people and systems engaged in leadership development. "Fast-changing and unpredictable health systems require creative, intelligent and resilient leaders" The norm in leadership training is formal, residential training programmes which face a number of limitations and can be disruptive to service delivery. The participants brainstormed how training institutions and governments can better support public health sector leaders to realise their leadership potential through enabling learning in the workplace. The report addresses several questions including: - What are the key challenges faced by leaders trying to operate effectively in the public health sectors of their own countries? - What type of leadership does the public health sector need? - What tools and approaches can best to support workplace-based learning? -How can we make workplace-based training sustainable? The informal report is intended to generate excitement for designing and supporting workplace-based learning in low- and middle-income country settings. It also includes detailed sections outlining experiences, strategies, critical reflections and recommended techniques that were discussed during the workshop. The report also recommends useful resources for further development

#FeesMustFall and the campaign for universal health coverage

This editorial reflects on how #FeesMustFall highlighted the political and social upheaval that results from extreme income inequity and inequitable access, problems that beset the health sector as well. It presents data showing how per capita health expenditure declined for a decade after 1994, despite the burgeoning HIV/AIDS epidemic, a blow from which the health system is still trying to recover. The underlying reason for this was a macroeconomic policy that placed constraints on taxation and goverment expenditure on social services. The article shows how South Africa (SA)'s tax-to-GDP ratio is much lower than other middle-income countries, and argues that raising this limit is essential for development. Spending on health and education should be seen as an investment in the SA economy. The Department of Health needs to argue this case in Cabinet and demonstrate the effectiveness of health spending through efficient service delivery and fighting corruption

Expansion of the private health sector in east and southern Africa

Comprehensive policies on privatization in the health sector need to be developed, together with robust regulations and enhanced capacities for monitoring activity. The paper explores increased private, for-profit activity in the health sector in the region. It identifies issues of concern, indicating some features of financing that may lead to private sector expansion that does not support social objectives. The paper recommends that governments reconsider financing incentives in view of effects such as private sector capture of public subsidies

Where the action isn't, that's where it is

Contribution to ARI Remix. ARI remix is a three-year digital humanities, artist interviews and oral history project collecting and presenting memories of Australian Artist-run culture in Queensland, New South Wales and the Australian Capital Territory between 1980 and 2000. Its focus is fleshing out and illuminating the ephemeral and neglected histories of the many lively and socially engaged artistic scenes along the east coast of Australia during the last two decades of the 20th century

The FGF receptor uses the endocannabinoid signaling system to couple to an axonal growth response

Akey role for DAG lipase activity in the control of axonal growth and guidance in vitro and in vivo has been established. For example, DAG lipase activity is required for FGF-stimulated calcium influx into neuronal growth cones, and this response is both necessary and sufficient for an axonal growth response. The mechanism that couples the hydrolysis of DAG to the calcium response is not known. The initial hydrolysis of DAG at the sn-1 position (by DAG lipase) will generate 2-arachidonylglycerol, and this molecule is well established as an endogenous cannabinoid receptor agonist in the brain. In the present paper, we show that in rat cerebellar granule neurons, CB1 cannabinoid receptor antagonists inhibit axonal growth responses stimulated by N-cadherin and FGF2. Furthermore, three CB1 receptor agonists mimic the N-cadherin/FGF2 response at a step downstream from FGF receptor activation, but upstream from calcium influx into cells. In contrast, we could find no evidence for the CB1 receptor coupling the TrkB neurotrophin receptor to an axonal growth response in the same neurons. The observation that the CB1 receptor can couple the activated FGF receptor to an axonal growth response raises novel therapeutic opportunities

Does expanding fiscal space lead to improved funding of the health sector in developing countries?: lessons from Kenya, Lagos State (Nigeria) and South Africa

This article examines whether increased tax revenue in the three territories of Kenya, Lagos State (Nigeria) and South Africa was accompanied by improved resource allocation to their public health sectors, and explores the reasons underlying the observed trends.CW201