90 research outputs found

    A step too far? Making health equity interventions in Namibia more sufficient

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    BACKGROUND: Equality of health status is the health equity goal being pursued in developed countries and advocated by development agencies such as WHO and The Rockefeller Foundation for developing countries also. Other concepts of fair distribution of health such as equity of access to medical care may not be sufficient to equalise health outcomes but, nevertheless, they may be more practical and effective in advancing health equity in developing countries. METHODS: A framework for relating health equity goals to development strategies allowing progressive redistribution of primary health care resources towards the more deprived communities is formulated. The framework is applied to the development of primary health care in post-independence Namibia. RESULTS: In Namibia health equity has been advanced through the progressive application of health equity goals of equal distribution of primary care resources per head, equality of access for equal met need and equality of utilisation for equal need. For practical and efficiency reasons it is unlikely that health equity would have been advanced further or more effectively by attempting to implement the goal of equality of health status. CONCLUSION: The goal of equality of health status may not be appropriate in many developing country situations. A stepwise approach based on progressive redistribution of medical services and resources may be more appropriate. This conclusion challenges the views of health economists who emphasise the need to select a single health equality goal and of development agencies which stress that equality of health status is the most important dimension of health equity

    Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia

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    Many people with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in Namibia have access to antiretroviral drugs but some still use traditional medicines to treat opportunistic infections and offset side-effects from antiretroviral medication. Namibia has a rich biodiversity of indigenous plants that could contain novel anti-HIV agents. However, such medicinal plants have not been identified and properly documented. Various ethnomedicines used to treat HIV/AIDS opportunistic infections have not been scientifically validated for safety and efficacy. These limitations are mostly attributable to the lack of collaboration between biomedical scientists and traditional healers. This paper presents a five-step contextual model for initiating collaboration with Namibian traditional healers in order that candidate plants that may contain novel anti-HIV agents are identified, and traditional medicines used to treat HIV/AIDS opportunistic infections are subjected to scientific validation. The model includes key structures and processes used to initiate collaboration with traditional healers in Namibia; namely, the National Biosciences Forum, a steering committee with the University of Namibia (UNAM) as the focal point, a study tour to Zambia and South Africa where other collaborative frameworks were examined, commemorations of the African Traditional Medicine Day (ATMD), and consultations with stakeholders in north-eastern Namibia. Experiences from these structures and processes are discussed. All traditional healers in north-eastern Namibia were willing to collaborate with UNAM in order that their traditional medicines could be subjected to scientific validation. The current study provides a framework for future collaboration with traditional healers and the selection of candidate anti-HIV medicinal plants and ethnomedicines for scientific testing in Namibia

    ECONOMIC INTEGRATION FOR DEVELOPMENT IN EASTERN AND SOUTHERN AFRICA: ASSESSMENT AND PROSPECTS

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    Summary Eastern and Southern Africa has a long history of efforts to achieve operational economic integration and a complex set of overlapping institutional frames. The gains from successful cooperation are agreed ? the basic issues turn on how to attain them. In this context the experiences of the two key actors, PTA (Preferential Trade Area) and SADC (Southern African Development Community), offer insights into the strengths and weaknesses of a broad, secretariat?led trade barrier reducing organization and a narrower (geographically), key sector production coordination, country?led one (SADC). The divergences ? as well as history ? have hampered attempts to coordinate or to merge them and their responses to the opportunities and challenges posed by the re?entry of South Africa into Africa. The latter raises rather more complex issues (and ones less threatening ? or promising in some respects ? to its Eastern and Southern African region potential partners) than is sometimes supposed. Resumé efforts pour d'obtenir l'intégration économique et de rendre celle?ci opérationnelle dans le contexte d'une série complexe de cadres institutionnels parfois superposés. Les gains résultant des réussites dans la coopération ne sont pas contestés: les questions fondamentales tournent autour des moyens d'y parvenir. Dans ce contexte l'expérience de deux acteurs principaux (la PTA – Preferential Trade Area ou Zone commerciale privilégiée et la SADC – Southern African Development Community ou Communauté de développement de l'Afrique australe) offrent des aperçus quant aux avantages et désavantages de l'existence d'une organisation de grande envergure et fondée sur secrétariat, consacrée à la réduction des barrières douannières, et d'une autre organisation, cette fois limitée en termes de sa superficie géographique et menée par des pays, qui cherche à coordiner la production dans les secteurs clef: la SADC. Leurs divergences, et l'histoire même, ont servi d'entrave aux efforts de les coordiner ou de les faire fusionner, surtout en ce qui concerne les nouvelles possibilités et le challenge même de la réintégration de l'Afrique du Sud dans la grande Afrique. Cette réintégration soulève des questions un peu plus complexes (et moins menaçantes) et aussi, moins promettrices sous certains jours pour ses éventuels partenaires dans les régions orientales et australes de l'Afrique) qu'on ne le supposerait parfois. Resumen El Africa oriental y el Africa austral tienen un largo historial de esfuerzos para alcanzar la integración económica operacional y un complejo grupo de estructuras institucionales superpuestas. Los beneficios de una cooperación exitosa no están en discusión ? el punto básico es cómo obtenerlos. En este contexto las experiencias de dos actores clave, (la PTA?Preferential Trade Area o Zona de Comercio Privilegiado, y la SADC ? Southern Africa Development Community o Comunidad para el Desarrollo de Africa Austral), ofrecen interesantes revelaciones sobre los puntos fuertes y débiles de una amplia y burocrática barrera comercial que reduce la organización, y la coordinación de la producción en sectores clave de un área geográfica más reducida, de orientación nacional. Las divergenias ? así como la historia ? han estorbado intentos de combinar o coordinar estos dos aspectos y sus respuestas a las oportunidades o desafíos que presenta el reingreso de Sudafrica al Africa. Esto último plantea más asuntos complejos de los que a veces se suponen (y menos amenazantes ? más prometedores en alugunos aspectos) para sus socios comerciales en potencia en Africa oriental y Africa del sur

    Measuring women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso

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    Time to stop polishing the brass on the Titanic: moving beyond ‘quick-and-dirty’ teacher education for inclusion, towards sustainable theories of change

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    Interest in inclusive education in the global south has grown significantly since the adoption of the Salamanca Statement in 1994. Increasingly, those who fund and provide education want to be seen taking action on inclusion generally and disability inclusion specifically. However, the much-welcomed enthusiasm to respond to global commitments is not always matched with the necessary expertise and commitment to longer-term action and change. The growth in inclusive education policies and pilot projects in the last decade is hard to miss, but changes resulting from these interventions are often less apparent. Why is that? Drawing on the Enabling Education Network’s 22 years of experience as a global inclusive education network and consultancy provider, we present alternative pathways for change in teacher education for inclusion. We stress that change in teaching practice remains limited not because inclusive education is a fundamentally flawed concept, but because too much focus is given to ‘quick-and-dirty’ trainings that quickly yield donorpleasing statistics and publicity-attracting case studies, but fail to elicit sufficiently extensive and sustainable change to education systems and cultures
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