This paper documents health experiences and the public health activities of the Tigray People's Liberation Front (TPLF). The paper provides background data about Tigray and the emergence of its struggle for a demo...
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This paper documents health experiences and the public health activities of the Tigray People's Liberation Front (TPLF). The paper provides background data about Tigray and the emergence of its struggle for a democratic Ethiopia. The origins of the armed struggle are described, as well as the impact of the conflict on focal health systems and health status. The health-related activities and public health strategies of the TPLF are described and critiqued in some detail, particular attention is focused on the development of the baito system, the emergent local government structures kindled by the TPLF as a means of promoting local democracy, accountability, and social and economic development. Important issues arise from this brief case-study, such as how emerging health systems operating in wartime can ensure that not only are basic curative services maintained, but preventive and public health services are developed. Documenting the experiences of Tigray helps identify constraints and possibilities for assisting health systems to adapt and cope with ongoing conflict, and raises possibilities that in their aftermath they leave something which can be built upon and further developed. It appears that promoting effective local government may be an important means of promoting primary health care.
Since the Stockholm County Council introduced a system of purchasers and providers there has been a quest for population-based resource allocation models to allocate monies to purchasers of health care. In contrast to...
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Through a Benin-Canada participatory research initiative which included both Benin and Canadian nongovernmental organizations, a local capacity to produce and market bednets for the prevention of malaria was developed...
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Through a Benin-Canada participatory research initiative which included both Benin and Canadian nongovernmental organizations, a local capacity to produce and market bednets for the prevention of malaria was developed. The development process began following a community-based assessment of local needs and skills. All materials for the manufacture and distribution of the bednets were obtained locally with the exception of the netting which was imported from Canada. The sustainability of the enterprise is enhanced by the community's recognition of the importance of malaria and the culturally acceptable practice of bednet use.
The new political era in South Africa offers unique opportunities for the development of more equitable health care policies. However, resource constraints are likely to remain in the foreseeable future, and efficienc...
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The new political era in South Africa offers unique opportunities for the development of more equitable health care policies. However, resource constraints are likely to remain in the foreseeable future, and efficiency therefore remains an important concern. This article describes the guiding principles and methods used to develop a coherent and objective plan for comprehensive primary health care facilities in Soweto. The article begins with an overview of the context within which the research was undertaken. Problems associated with planning in transition are highlighted, and a participatory research approach is recommended as a solution to these problems. The article goes on to describe how the research methods were developed and applied in line with the principles of participatory research. The methods were essentially rapid appraisal techniques which included group discussions, detailed checklists, observation, record reviews and the adaptation of international and local guidelines for service planning. It is suggested that these methods could be applied to other urban areas in South Africa and elsewhere, and that they are particularly appropriate in periods of transition when careful facilitation of dialogue between stakeholders is required in tandem with the generation of rapid results for policy-makers.
The application of Participatory Rural Appraisal methods (PRA) to the topic of sexual health enabled us to explore key factors concerning local people's perceptions regarding HIV/AIDS and STDs and to plan collecti...
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The application of Participatory Rural Appraisal methods (PRA) to the topic of sexual health enabled us to explore key factors concerning local people's perceptions regarding HIV/AIDS and STDs and to plan collectively to address the emerging issues. Conducting the process in a gender sensitive way enabled people to feel safe enough to express their own opinions, and having gained confidence in their peer groups, to share ideas later with the whole community in a joint planning exercise. Nevertheless one group was identified as difficult to reach and whose needs could not be met in a group for reasons of confidentiality. While the methodology itself clearly has great potential in planning around specific health issues, there are, nevertheless, limitations. Although the approach and the tools used are simple and accessible, the skills needed to analyze the information are more complex and demanding. The training given did not manage to equip facilitators adequately with these analytical skills and in the future will be more experience based and geared towards developing analysis and the ability to formulate questions. In addition, since the project is not permanently resident in the area, intensive support within the District is necessary to increase the chances of sustainability.
To improve human immunodeficiency virus (HIV) prevention efforts nationwide, the Centers for Disease Control and Prevention (CDC) has funded HIV Prevention Community Planning, an initiative that promotes parity, repre...
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To improve human immunodeficiency virus (HIV) prevention efforts nationwide, the Centers for Disease Control and Prevention (CDC) has funded HIV Prevention Community Planning, an initiative that promotes parity, representativeness, and inclusion of community and the application of scientific principles for decision making. This initiative was welcomed enthusiastically in New York City, an AIDS epicenter with limited prevention resources. In the first year of implementation, the New York City Department of Health (NYCDOH) supported a comprehensive evaluation of the planning initiative This article reviews the evaluation design, including its process and outcome components, the study findings, and its strengths and limitations. It provides overall guidance for those who are assessing prevention planning in HIV as well as other health areas.
This assessment helped shape the practice of a nurse administered mobile clinic serving three rural communities. Needed services were identified and existing services were customized to improve the overall health of t...
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This assessment helped shape the practice of a nurse administered mobile clinic serving three rural communities. Needed services were identified and existing services were customized to improve the overall health of the communities. With the dynamic state of health care systems, each practice is subject to influence by managed care and populations who, in turn, respond with changes in need, resources, and adaptation to the system dynamics. Nurse practitioners struggling to match resources and patient needs could use a similar research design to assess their practice, discover significant relationships, and redesign practice plans to fit specific practice settings.
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