South-South cooperation in health professional education : a literature review

In the literature on the evolution of funding approaches there is criticism of traditional funding strategies and the promotion of inclusive models, such as South-South Cooperation (SSC) and triangular models. The latter are felt to have a number of advantages. This article has four broad objectives: (i) to present a literature review on the evolution of Southern approaches to development co-operation; (ii) to indicate examples of current co-operative programmes in health and health professional education in Africa; (iii) to assess the advantages and disadvantages of these models; and (iv) to mention some emerging issues in monitoring and evaluation. The Boolean logic approach was used to search for applicable literature within three topic layers. Searches were conducted using PubMed, PLoS and other accessible databases. An initial draft of the article was presented to a group of academics and researchers at the Flemish Inter-University Council (VLIR-UOS) Primafamed annual workshop held in August 2010 in Swaziland. Comments and suggestions from the group were included in later versions of the article. It is important to note that the existence of various funding models implemented by a variety of actors makes it difficult to measure their effects. In health and health professional education, however, SSC and triangular models of aid provide conditions for more effective programming through their focus on participation and long-term involvement. With an eye towards evaluating programmes, a number of salient issues are emerging. The importance of context is highlighted

Socio-economic factors associated with mental health in Johannesburg

M.A. (Development Studies)Mental health is an increasingly important field of interest in epidemiology and development. The understanding of mental health and its effect on the functioning of individuals is increasingly being viewed through the lens of vulnerability. There are efforts to predict mental health outcome by defining vulnerability and exposure factors (Aneshensel, Rutter & Lachenbruch 1991). The research aims to explore associations between household well-being and self-reported mental health, measured by the Self Reporting Questionnaire-20 (SRQ-20). The argument is for the inclusion of mental health measures in general household surveys. It is furthermore a motivation for the inclusion of certain indicators in quantitative research on health, poverty and livelihoods. The study represents a secondary analysis of existing data that was collected as part of the Johannesburg Poverty and Livelihoods Study (JPLS). The study by De Wet, Patel, Korth & Forrester (2008: 6-7) used a questionnaire on household socio-economics and health, as well as the SRQ-20 battery of questions. Eighteen composite variables were created. They were tested for association with the binary outcome of the SRQ-20. Variables that showed significant associations were included in a series of logistic regression models. Findings show the importance of demographic variables (chapter four): area of residence, age and gender. In terms of poverty and livelihood strategies (chapter five), the presence of livelihood strategies maintained an important relationship to the mental health variable. Food insecurity, access to basic services, access to social security and access to informal financial support emerged as important to the mental health outcome of the individual. In terms of health and social participation (chapter six), the health of the household showed an important relationship to the mental health outcome. Participation in civil groupings, the experience of detrimental shock, and the perception of the individual of safety furthermore influenced the mental health outcome at an individual level. Lastly, the presence of care burdens in the household is an important indicator of individual mental health

Building consensus on key priorities for rural health care in South Africa using the Delphi technique

Background: South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods: The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results: Response rates ranged from 83% in the first round (n=44) to 64% in the final round (n=34). The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH), governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion: Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential