Public health

Against a background of growing access to, and increasing enthusiasm for the use of mobile phone technology in health services (mHealth) in low and middle income countries (LMICs), we reviewed the potential usefulness of mHealth for monitoring and evaluation (M&E) of the planned integration of community based health services (mHealth4CBS) in South Africa. It forms part of a portfolio of support for the development of M&E systems for community based PHC outreach teams currently being implemented as part of the PHC re-engineering process. The purpose of the investigation was both to shed light on an emerging field and to provide recommendations for policy makers.

Every day, approximately 1000 women die in childbirth or from a pregnancy-related complication.1 Maternal death can occur at any time in pregnancy, but delivery is by far the most dangerous time for both the mother and the baby. The vast majority of these deaths can be prevented if access to emergency obstetric care is ensured.

Experience shows us that at least 15 percent of all pregnant women worldwide encounter a life-threatening complication. In a conflict or a crisis, pregnant women are even more vulnerable because health services have collapsed, are inadequate or non-existent. But these women need access to quality emergency obstetric care whether they live in a conflict zone, in a refugee camp or under plastic sheeting after a devastating earthquake.

Global Health Watch 3 comprises five broad sections. The first section, entitled ‘The global political and economic architecture’, provides an analysis to locate the decisions and choices that impact on health. The second section, ‘Health systems – current issues and debates’, provides a view of current issues and debates on health systems across the world, from which it is possible to draw appropriate lessons and propose concrete actions for promoting health. The third section, ‘Beyond health care’, is a recognition that health encompasses areas beyond the provision of health care.

Background: Due to intensified measles immunization efforts, measles mortality has decreased substantially worldwide, particularly in Sub-Saharan Africa (SSA). The World Health Organization (WHO) estimated a 92% decrease in measles-related deaths in the WHO AFRO region for the period 2000–2008. Recently, the AFRO region established a measles pre-elimination goal and experts have suggested engaging in a measles eradication campaign at the global level. However, recent large-scale outbreaks in many Sub-Saharan African countries present a challenge to measles control efforts. This paper examines measles immunization and the impact of measles supplemental immunization activities (SIAs) on routine immunization coverage in South Africa (SA).

The SAHR 2011 provides valuable policy and empirical information on a range of issues that are related to and impact on the Negotiated Service Delivery Agreement and primary health care re-engineering as envisaged by the National Department of Health (NDoH). A range of experts provide commentary on topics ranging from rural health, health technology to human resources. SAHR 2011 also contains a section on core health issues, where developments in health information systems, financing health care, and health legislation and policy are discussed. The Review concludes with the Indicators chapter which presents a selection of the best available data on the functioning and performance of the health system.

A global review of the key interventions related to reproductive, maternal, newborn and child Health

Executive Summary

Why reproductive, maternal, newborn and child health?

Poor maternal, newborn and child health remains a significant problem in developing countries. Worldwide, 358 000 women die during pregnancy and childbirth every year and an estimated 7.6 million children die under the age of five. The majority of maternal deaths occur during or immediately after childbirth. The common medical causes for maternal death include bleeding, high blood pressure, prolonged and obstructed labour, infections and unsafe abortions.

Health Systems Trust (HST) will celebrate twenty years of supporting health service delivery in South and southern Africa in 2012. This is a long time in the life of any non-governmental organisation and we attribute this to HST’s enduring commitment to quality and never being content to deliver simply technically correct products and services that merely meet the minimum requirements of health systems strengthening policies and frameworks. Through our work we strive to inspire – not only our clients, but also ourselves. We strive to be associated with products and services that are inspirational and we realise how important it is to have our own internal systems operating like clockwork to enable us to execute our vision and mission.

In January 2010 at the World Economic Forum, the Bill and Melinda Gates Foundation launched the Decade of Vaccines by pledging $10 billion over the next 10 years to support worldwide efforts to develop and deliver vaccines to the world’s poorest countries. The foundation also challenged other global partners to demonstrate their continuing commitment and, in so doing, to dramatically reduce child mortality by the end of the decade. This is a tremendous opportunity for transforming global health and could have significant consequences for child survival while expanding the impact of vaccines across the lifespan, but there is no easy formula for success.

This report provides evidence that health inequities can and need to be addressed through a holistic approach. Health inequities, and the resulting social injustice are closely linked with other issues such as poverty, gender inequality and human rights violations which in turn, have an impact on education, transport, health, agriculture, and overall well-being. Our interventions should therefore be multi-sectoral, going beyond health to address social and economic determinants – malnutrition, alcohol abuse, poor housing, indoor air pollution and poverty, among others.

The study highlights the likely impact of climate change on children’s health, education, nutrition, safety and access to adequate housing and sanitation in South Africa – both directly and indirectly. The study presents a body of evidence that South Africa’s climate is already changing.