Social Issues

Between 31 January and 2 February 2012, the World Health Organization (WHO) convened a meeting of experts to discuss recent research on use of hormonal contraception by women at high risk of HIV and those currently living with HIV and its implications. The Technical Consultation brought together 75 participants from 18 countries; 18 agencies were represented. The multidisciplinary group comprised experts in international family planning and HIV, including clinicians, epidemiologists, researchers, programme managers, policy-makers, guideline methodologists, reproductive biologists and pharmacologists, HIV advocates, and women’s health advocates.

There is widespread consensus that providing universal, sustainable, affordable and quality health services underpins efforts to achieve equitable health outcomes. UNICEF in 2010-2011 conducted a two-phase landscape analysis, funded by the Rockefeller Foundation, to investigate how health insurance and other social health protection mechanisms contribute to achieving universal health coverage (UHC). The work built on previous research examining the protection from impoverishment that health insurance provides to vulnerable groups, the potential for increasing and expanding insurance coverage, and the options for and constraints limiting the use of insurance to attain UHC. 

From 26-28 April 2012, EQUINET held a regional methods workshop in Cape Town, South Africa. It gathered the lead institutions of country teams in the Equity Watch work, the EQUINET steering committee, regional and international agencies and networks involved in work on health equity. The workshop aimed to: provide training on equity analysis and discuss future approaches to capacity building on equity analysis; review Equity Watch work at country level and the learning and implications from the work for future monitoring of health equity within countries; and review and discuss the draft regional Equity Watch and the follow up and dissemination.

This report was commissioned by the Regional Network for Equity in Health in East and Southern Africa (EQUINET). It highlights areas of concern for gender equity in health in East and Southern Africa (ESA), based on a review of published literature. The report provides examples of key areas of gender equity in health drawn from the literature. It raises dimensions of gender equity in health in relation to the contexts for and social determinants of health; in health outcomes; in health systems and options for acting on gender equity in health. The report does not provide a systematic analysis using household data and is not a comprehensive assessment of all dimensions of gender equity.

This is the twelfth volume of Gender, Poverty and Environmental Indicators on African Countries published by the Statistics Department of the African Development Bank Group. The publication also provides some information on the broad development trends relating to gender, poverty and environmental issues in the 53 African countries.

Gender, Poverty and Environmental Indicators on African Countries 2012 is divided in three main parts:

Within ten years of implementing the national Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme in South Africa interventions to prevent mother-to-child transmission (MTCT) of HIV are now offered in more than 95% of public antenatal and maternity facilities country-wide. However, this is the first national evaluation to determine the effectiveness of the National PMTCT programme. The 2010 South African PMTCT Evaluation (SAPMTCTE) will serve as a baseline to monitor the effectiveness of the antenatal and intrapartum aspects of the national PMTCT programme (i.e., early MTCT rates).

Three countries in Southern Africa have the highest adult HIV prevalence in the world: Swaziland (25.9%), Botswana (24.8%), and Lesotho (23.6%). Fiscal policy is crucial for addressing this HIV/AIDS crisis. Utilizing a calibrated model, this paper investigates the impact of fiscal policy on reducing the HIV/AIDS incidence rates in these countries. In particular, we studied the welfare impact of different taxation and debt paths in these countries in reducing the HIV/AIDS prevalence rates. This is particularly important given the current concerns about dwindling foreign aid (especially the global AIDS fund), and the fiscal deterioration and sustainability in these countries.

The field of global health is witnessing a shift in focus from disease-driven initiatives to projects aimed at increasing the sustainability and strengthening of health systems. A crucial component to this is universal health coverage (UHC), which seeks to address financing schemes for health, separate from efforts to provide both adequate numbers of health workers and structures for health-care delivery. UHC may be provided by government or through a combination of private insurance schemes, public-sector planning, and employer-based programs. Countries across the world, from China and India to Rwanda and Mexico, are beginning to implement different universal health coverage schemes, marking a rise in interest and political will for universal health coverage.

New WHO guidelines recommend offering HIV testing and counselling to couples, wherever HIV testing and counselling is available, including in antenatal clinics. For couples where only one partner is HIV positive, the guidelines recommend offering antiretroviral therapy to the HIV positive partner, regardless of his/her own immune status (CD4 count), to reduce the likelihood of HIV transmission to the HIV negative partner.