Law

There have been claims that Unicef is about to form partnerships with companies that produce infant formula, and market beast milk substitute products in violation of the international code of marketing of breast milk substitutes.

Technical Report to Chapter 13 of the 1998 SA Health Review

A workshop to develop guidelines. The effects of commercial products from some industries on the health and well being of communities has been a subject of debate for many years. The tobacco, alcohol and infant formula industries have been under special scrutiny in this regard. In the case of the infant formula industry, the debates have focused more on how breast milk substitutes affect health promotion efforts aimed at promoting breastfeeding. To this end, international health groups such as UNICEF and WHO have embarked on global campaigns, some of which have led to the formulation of a number of international codes. These codes are intended to help regulate the use and marketing of breast milk substitutes, for example, the international code of marketing of breast milk substitutes adopted by the World Health Assembly in 1981.

This issue of HST Update documents progress towards district systems development from all three angles. First, we examine the policy environment in which district development is occurring, and assess the degree to which outstanding policy issues are being resolved. Second, we guage provincial efforts to restructure health services toward district-based care. Finally, we examine several initiatives which home in on service delivery, and describe how these initiatives help give practical meaning to district-based health care.

The Reconstruction and Development Programme (RDP) states that the PHC system must encourage the training, use and support of CHWs as cost-effective additional or alternative personnel. Supporters of this view are frustrated by the uneven development of CHW initiatives in different provinces and the fact that there is still no clear national policy direction on their role.

The Department of Health adopted the district health system as the vehicle to render primary health care in 1995/6. This policy is reflected, inter alia, in the White Paper on the Transformation of the National Health System published in April 1997. In addition, the view that local government should govern health districts as capacity is developed at municipal level, was also expressed a few years ago and continues to be the policy of the Department. The link between local government and health districts is a logical one given the need for local accountability, the importance of community participation and the need to meet local health needs. These and other principles are listed in the district health system policy document published towards the end of 1995. In addition, the Constitution makes provision for municipalities to render various services, either as delegated or assigned functions or, as in the case of municipal health services, as core functions.