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In 2006, Kwan Kew Lai left her full-time position as a professor in the United States to provide medical humanitarian aid to the remote villages and the war-torn areas of Africa. This memoir follows her experiences from 2006 to 2013 as she provided care during the HIV/AIDs epidemics, after natural disasters, and as a relief doctor in refugee camps in Kenya, Libya, Uganda and in South Sudan, where civil war virtually wiped out all existing healthcare facilities. Throughout her memoir, Lai recounts intimate encounters with refugees and internally displaced people in camps and in hospitals with limited resources, telling tales of their resilience, unflinching courage, and survival through extreme hardship. Her writing provides insight into communities and transports readers to heart-achingly beautiful parts of Africa not frequented by the usual travelers. This is a deeply personal account of the huge disparities in the healthcare system of our "global village" and is a call to action for readers to understand the interconnectedness of the modern world, the needs of less developed neighbors, and the shortcomings of their healthcare systems.
Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.
In August 2008, Heads of State of the Southern African Development Community adopted the ground-breaking SADC Protocol on Gender and Development. This followed a concerted campaign by NGOs under the umbrella of the Southern Africa Gender Protocol Alliance. The SADC Gender Protocol is the only sub-regional instrument that brings together existing global and continental commitments to gender equality and enhances these through time bound targets. Aligned to Millennium Development Goal Three, the original 28 targets of the Protocol targets expire in 2015. Now that 2015 is here, we need to step back, assess and reposition. In June 2014, SADC Gender Ministers agreed to review the targets of the Gender Protocol in line with the Sustainable Development Goals (SDGs). In May this year, ministers added that they want the Protocol to be accompanied by a Monitoring, Evaluation and Results Framework. The 2015 Barometer shows that implementation is now the biggest missing gap in the quest for gender equality. Now is the time to strengthen resolve, reconsider, reposition, and re-strategise for 2030. SADC GENDER PROTOCOL BAROMETER • 2015 2015 is here! In August 2008, Heads of State of the Southern African Development Community adopted the ground-breaking SADC Protocol on Gender and Development. This followed a concerted campaign by NGOs under the umbrella of the Southern Africa Gender Protocol Alliance. The SADC Gender Protocol is the only sub-regional instrument that brings together existing global and continental commitments to gender equality and enhances these through time bound targets. Aligned to Millennium Development Goal Three, the original 28 targets of the Protocol targets expire in 2015. Now that 2015 is here, we need to step back, assess and reposition. In June 2014, SADC Gender Ministers agreed to review the targets of the Gender Protocol in line with the Sustainable Development Goals (SDGs). In May this year, ministers added that they want the Protocol to be accompanied by a Monitoring, Evaluation and Results Framework. The 2015 Barometer shows that implementation is now the biggest missing gap in the quest for gender equality. Now is the time to strengthen resolve, reconsider, reposition, and re-strategise for 2030.
The SADC Protocol on Gender and Development is the only sub-regional instrument in the world that brings together global and continental commitments to gender equality in one instrument used to enhance accountability. The Southern African Gender Protocol Alliance is a network of country and regional NGOs that campaigned for the Protocol, its updating, implementation and tracking. Originally aligned to the Millennium Development Goals that expired in 2015, SADC Gender Ministers updated the Protocol and aligned it to the Sustainable development Goals (SDGs), Beijing Plus Twenty and the Africa Agenda 2063 in 2016. In July 2017, the Ministers adopted a Monitoring, Evaluation and Reporting Framework (MERF) that will be the basis of future reporting. Now in its ninth edition, the 2017 Barometer is the first assessment of the Post-2015 SADC Gender Protocol. Moving with the times, the Alliance has expanded the two key main yardsticks in the Barometer: the SADC Gender and Development Index (SGDI) and the Citizen Score Card (CSC). The Barometer incorporates many MERF and SDG indicators, as well as its own unique measures of voice, choice and control. The Barometer also introduces the Gender Responsive Assessment of Constitutions and Laws conducted by Alliance experts and networks around the region. A wealth of data, insights and analysis awaits all readers of the Barometer, that will also be made available online and in multi-media formats. The “SADC we want” is one in which citizens engage; step it up for gender equality, and make sure we achieve Planet 50/50 by 2030!
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
This book is written by Southern African social welfare, social work, social development, social security and social policy academics, practitioners and advocates who have varying degrees of experience. The authors who contributed chapters to this book added their perspectives to ongoing debates about academic areas in the region. Thus, the book’s primary objective is to discuss the development of social welfare and social work in Southern Africa. In doing so, it endeavours to contribute to the existing body of knowledge on social welfare and social work in the region. The chapters are examined through different theoretical lenses and historical perspectives. In this book, African scholars, academics, and practitioners provide a deep and critical reflection of social welfare, social work, and related disciplines during the colonial and post-colonial era, a period characterised by a deliberate move by Africa’s political administrations to focus on nation-building and to attempt to make Africa a global player. Despite being endowed with rich natural resources like minerals; agriculture; and solid family and extended family life, the continent is weak globally. Furthermore, the book focuses on the pre-colonial period – a golden thread running through the chapters. The book discusses the colonial era when Western countries’ capture and oppression of Africa characterised the continent’s history. This book is an appropriate publication at this point in our history; a resource that can be used to generate appropriate narratives and questions within the social welfare and social development sector, particularly on delivery, education and training.
Micronutrient deficiencies are common across the developing world and have major effects on the health outcomes of its population. Although this is well understood, many countries find it difficult to bring about policy change in this regard. This paper uses micronutrient policies designed and implemented in Malawi as a case study to shed light on the barriers and gaps faced by developing countries for similar programs and policies. To understand the drivers of policy change, this paper uses the kaleidoscope model to trace the policy processes of three major micronutrients—iodine, vitamin A, and iron. Using a select set of policy process tools, as well as field interviews with key informants who were part of Malawi’s micronutrient policy process, the authors test a set of hypotheses on 16 variables that drive policy change in the micronutrient policy sphere. Results indicate that much of the agenda setting for micronutrient policies and programs was triggered by external events that focused on the elimination of micronutrient deficiencies as part of the global development agenda. These events include the International Conference on Nutrition, the Millennium Development Goals, and, more recently, Scaling up Nutrition. The design of micronutrient policies and program interventions in Malawi was adopted by locally mandated ministries and institutions, in collaboration with development partners who provided both financial and technical support at the design stage. The adoption of micronutrient policies and intervention programs was driven primarily by external funding, particularly through supplementation programs related to vitamin A and iron. Adoption of fortification standards for vitamin A has been going on for more than a decade due to continuous resistance from the private sector, which faces additional costs and needs greater technical expertise. The biofortification method of micronutrient interventions for iron and vitamin A is externally driven and relatively new in Malawi. Although this method is widely accepted by policy makers, no concrete strategy has been developed for its design, adoption, and implementation. Further, supplementation and fortification programs continue to face implementation challenges due to poor physical infrastructure and monitoring systems. However, the national institutional architecture required for agenda setting, design, adoption, implementation, evaluation, and review to address micronutrient deficiencies is in place in Malawi. The system needs continued support from development partners for effective functioning at all levels. The use of various tools for the policy change part of the kaleidoscope model indicate that policy change is a dynamic process; over time, changes in the nature and composition of the members of policy and institutional architecture can result in different policy outcomes. The Malawi case study demonstrates two things. First, local leadership is crucial in keeping micronutrient deficiencies on the policy-making agenda, and second, it matters where coordinating power is placed in the policy hierarchy. This paper finds that, even with policy champions, adopted policies will face implementation challenges unless they are supported with adequate resources and are systematically followed through to final execution and delivery.
In the wake of the AIDS pandemic, legions of organizations and compassionate individuals from faraway places descended on Africa to offer help and save lives. Ann Swidler and Susan Cotts Watkins vividly describe the often mismatched expectations and fantasies of altruists who dream of transforming lives, of the villagers who desperately seek help, and of the brokers on whom both Western altruists and impoverished villagers must rely. Based on years of fieldwork in the heavily AIDS-affected country of Malawi, this incisive, irreverent book digs into the sprawling AIDS enterprise and unravels the paradoxes of policy and practice. All who want to do good—from idealistic volunteers to world-weary development professionals—depend on brokers as guides, fixers, and cultural translators. The mutual misunderstandings among these players create all the drama of a romance: longing, exhilaration, disappointment, heartache, and sometimes an enduring connection. A Fraught Embrace unveils the tangled relations of those involved in the collective struggle to contain an epidemic.