Background: Action on the social determinants of health (SDH) is relevant for reducing health inequalities. This is particularly the case for South Africa (SA) with its very high level of income inequality and inequalities in health and health outcomes. This paper provides evidence on the key SDH for reducing health inequalities in the country using a framework initially developed by the World Health Organization. Objective: This paper assesses health inequalities in SA and explains the factors (i.e. SDH and other individual level factors) that account for large disparities in health. The relative contribution of different SDH to health inequality is also assessed.

Design: A cross-sectional design is used. Data come from the third wave of the nationally representative National Income Dynamics Study. A subsample of adults (18 years and older) is used. The main variable of interest is dichotomised good versus bad self-assessed health (SAH). Income-related health inequality is assessed using the standard concentration index (CI). A positive CI means that the rich report better health than the poor. A negative value signifies the opposite. The paper also decomposes the CI to assess its contributing factors.

Results: Good SAH is significantly concentrated among the rich rather than the poor (CI0.008; pB0.01). Decomposition of this result shows that social protection and employment (contribution0.012; pB0.01), knowledge and education (0.005; pB0.01), and housing and infrastructure (0.003; pB0.01) contribute significantly to the disparities in good SAH in SA. After accounting for these other variables, the contribution of income and poverty is negligible.

Conclusions: Addressing health inequalities inter alia requires an increased government commitment in terms of budgetary allocations to key sectors (i.e. employment, social protection, education, housing, and other appropriate infrastructure). Attention should also be paid to equity in benefits from government expenditure. In addition, the health sector needs to play its role in providing a broad range of health services to reduce the burden of disease.

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If a child were to build a hospital out of Legos it might look like the new Children’s Hospital of Michigan Specialty Center, an irregularly shaped, multicolored facility slated to open in February in the Detroit suburb of Troy, Mich. “Everybody drives by it and says, ‘I know that’s for kids, but I’m not sure what it is,’” said Ron Henry, chief facilities engineering and construction officer at Tenet Healthcare’s Detroit Medical Center, which is building the facility. ….more

ABSTRACT

Next week, the UN General Assembly will call on member states to bid farewell to the Millennium Development Goals and adopt 17 new Sustainable Development Goals. John Maurice reports….more

ABSTRACTIntroduction:  The establishment of the rural clinical schools funded through the Commonwealth Department of Health and Ageing (now Department of Health) Rural Clinical Training and Support program over a decade ago has been a significant policy initiative in Australian rural health. This article explores the impacts of this policy initiative and presents the wide range of educational innovations contextualised to each rural community they serve.
Methods:  This article reviews the achievements of the Australian rural clinical and regional medical schools (RCS/RMS) through semi-structured interviews with the program directors or other key informants. The questions and responses were analysed according to the funding parameters to ascertain the numbers of students, types of student placements and range of activities undertaken by each university program.
Results:  Sixteen university medical schools have established 18 rural programs, creating an extensive national network of RCS and RMS in every state and territory. The findings reveal extensive positive impacts on rural and regional communities, curriculum innovation in medical education programs and community engagement activities. Teaching facilities, information technology, video-conferencing and student accommodation have brought new infrastructure to small rural towns. Rural clinicians are thriving on new opportunities for education and research. Clinicians continue to deliver clinical services and some have taken on formal academic positions, reducing professional isolation, improving the quality of care and their job satisfaction. This strategy has created many new clinical academics in rural areas, which has retained and expanded the clinical workforce. A total of 1224 students are provided with high-quality learning experiences for long-term clinical placements. These placements consist of a year or more in primary care, community and hospital settings across hundreds of rural and remote areas. Many programs offer longitudinal integrated clerkships; others offer block rotations in general practice and specialist clinics. Nine universities established programs prior to 2004, and these well-established programs are finding graduates who are returning to rural practice. Universities are required to have 25% of the students from a rural background. University admission policies have changed to encourage more applications from rural students. This aspect of the policy implements the extensive research evidence that rural-origin students are more likely to become rural practitioners. Additional capacity for research in RCS has influenced the rural health agenda in fields including epidemiology, population health, Aboriginal health, aged care, mental health and suicide prevention, farming families and climate change. There are strong research partnerships with rural workforce agencies, research centres for early career researchers and PhD students.
Conclusions:  The RCS policy initiative has vastly increased opportunities for medical students to have long-term clinical placements in rural health services. Over a decade since the policy has been implemented, graduates are being attracted to rural practice because they have positive learning experiences, good infrastructure and support within rural areas. The study shows the RCS initiative sets the stage for a sustainable future Australian rural medical workforce now requiring the development of a seamless rural clinical training pipeline linking undergraduate and postgraduate medical education.

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The announcement of the discovery by the Rising Star Expedition team of a new species of human relative, Homo naledi, has attracted unprecedented global media attention and coverage.

Described as the “biggest single discovery of its kind in Africa”, the announcement on 10 September 2015 also took social media by storm and the hastags, #HomoNaledi and #NalediFossils, trended at number one locally and internationally on the day.

Here is a taste of some of the major local and international television, radio, print, wire services and online media coverage:

Some early statistics:

·         10 September 2015: 16 000 people watched the live web streaming of the launch on the Wits website. You can watch a replay at streaming.wits.ac.za. The event was also broadcast live on eNCA, SABC and 702, among others.

·         15 September 2015: 160 000 page views and 16 000 downloads of the Homo naledi scientific paper from the open access journal eLife.

·         16 September 2015: Download this pdf for a selection of the South African coverage. (Warning: This file is more than 1GB.)

·         16 September 2015: 5 000 views and nearly 1 700 downloads of 3D data from #Homonaledi on MorphoSource at http://morphosource.org/index.php.

If you want to learn more about the discovery, visit www.wits.ac.za/homonaledi, or want to know what the hype is all about, watch this short video on the launch.

The  Homo naledi fossils will be on display to the public at the Maropeng Visitors Centre until 11 October 2015 in celebration of Heritage Month at a 25% discounted entry fee.

Representatives of national governments are now coming together to set the next development agenda, under the umbrella of the Sustainable Development Goals (SDGs), as the era of the Millennium Development Goals (MDG) concludes. In order to attain the new goals, it may help to revisit what worked — and what didn’t — in achieving the successes of the MDGs over the past 15 years….more

When the United Nations summit for the adoption of the post-2015 development agenda begins on September 25, the attainment of universal health coverage (UHC) is expected to garner substantial attention. Bolstered by increasing evidence that UHC improves health outcomes,1 countries are seeking to build health-related goals around the concept of health care for all. Yet many lower- and middle-income countries (LMICs) have not created UHC systems (see mapCountries That Have Adopted Reforms toward Universal Health Coverage.). How can the global community translate vision into policy, especially in the face of complicated politics? ….more

CITATION: Care Groups I: An Innovative Community-Based Strategy for Improving Maternal, Neonatal, and Child Health in Resource-Constrained Settings

Henry Perry, Melanie Morrow, Sarah Borger, Jennifer Weiss, Mary DeCoster, Thomas Davis, Pieter Ernst

doi: 10.9745/GHSP-D-15-00051

Glob Health Sci Pract September 10, 2015 vol. 3 no. 3 p. 358-369

http://www.ghspjournal.org/content/3/3/358

‘Care Groups use volunteers to motivate mothers to adopt key MCH behaviors. The volunteers meet as a group every 2–4 weeks with a paid facilitator to learn new health promotion messages. Key ingredients of the approach include: peer-to-peer health promotion, selection of volunteers by the mothers, a manageable workload for the volunteers (no more than 15 households per volunteer), frequent (at least monthly) contact between volunteers and mothers, and regular supervision of the volunteers.’

ABSTRACT:

In view of the slow progress being made in reducing maternal and child mortality in many priority countries, new approaches are urgently needed that can be applied in settings with weak health systems and a scarcity of human resources for health. The Care Group approach uses facilitators, who are a lower-level cadre of paid workers, to work with groups of 12 or so volunteers (the Care Group), and each volunteer is responsible for 10–15 households. The volunteers share messages with the mothers of the households to promote important health behaviors and to use key health services. The Care Groups create a multiplying effect, reaching all households in a community at low cost. This article describes the Care Group approach in more detail, its history, and current NGO experience with implementing the approach across more than 28 countries. A companion article also published in this journal summarizes the evidence on the effectiveness of the Care Group approach. An estimated 1.3 million households—almost entirely in rural areas—have been reached using Care Groups, and at least 106,000 volunteers have been trained. The NGOs with experience implementing Care Groups have achieved high population coverage of key health interventions proven to reduce maternal and child deaths. Some of the essential criteria in applying the Care Group approach include: peer-to-peer health promotion (between mothers), selection of volunteers by mothers, limited workload for the volunteers, limited number of volunteers per Care Group, frequent contact between the volunteers and mothers, use of visual teaching tools and participatory behavior change methods, and regular supervision of volunteers. Incorporating Care Groups into ministries of health would help sustain the approach, which would require creating posts for facilitators as well as supervisors. Although not widely known about outside the NGO child survival and food security networks, the Care Group approach deserves broader recognition as a promising alternative to current strategies for delivering key health interventions to remote and underserved communities.

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Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

https://www.coursera.org/course/commhealthworkers

Volunteer community health workers (CHWs) are a major strategy for increasing access to and coverage of basic health interventions. Our village health worker training course reviews the process of training and continuing education of CHWs as an important component of involving communities in their own health service delivery. Participants will be guided through the steps of planning training and continuing education activities for village volunteers. The course draws on real-life examples from community-directed onchocerciasis control, village health worker programs, community case management efforts, peer educators programs and patent medicine vendor training programs, to name a few.

Developed in collaboration with Johns Hopkins Open Education Lab.

Course Syllabus

• 1. Learning processes with adults
• 2. Identification and recruitment of trainees
• 3. Determining training needs for village volunteers
• 4. Setting learning objectives
• 5. Selecting appropriate learning methods
• 6. Mobilizing resources and planning logistics for training
• 7. Implementing the training program
• 8. A sample lesson/training session
• 9. Evaluation and follow-up
• 10. Supervision and continuing education

Recommended Background: Some background in community health programs is helpful but not necessary.

Course Format: This course will consist of weekly video lectures and readings. Learning progress will be assessed with weekly quizzes and two peer-graded training matrix exercises.

FAQ

Will I get a Statement of Accomplishment after completing this class? Yes. Students who successfully complete the class will receive a Statement of Accomplishment signed by the instructor.

Do I need to speak English to take this class? Yes. Lectures will be delivered in English, and assessments will be conducted in English.

William Brieger MPH, CHES, DrPH (Atunluse of Idere, Otun Ba’asegun of Igbo-Ora)

Abstract

The Rawdon Hills Community Health Centre (RHCHC) is a non-profit, integrated health care centre – built, owned and operated by the community and the people in the Rawdon Hills area of Hants County, Nova Scotia….more

Our Vision Remains the Same: A Conversation with Dr. Jack Geiger. Northwest Regional Primary Care Association CEO Bruce Gray had the opportunity to sit down with Dr. Geiger and discuss the storied past of community health centers in America and the opportunities the future presents. NWRPCA is proud to present a series of six featuring Dr. Geiger to commemorate the 50th anniversary of the American CHC movement…..more

The Victorian Healthcare Association (VHA) is an independent, not-for-profit peak body working to improve population health outcomes through the advancement of health service delivery across Victoria. Our members include public hospitals, rural and regional health services, aged care facilities, community health services and primary care providers. Established in 1938, the VHA follows the strategic direction of its board and aims to promote and influence debate on public health policy for the benefit of all Victorians by ….more

Somerset West Community Health Centre (SWCHC) is a non-profit, community-governed organization that provides primary health care, health promotion and community development services, using interprofessional teams of health and social service providers. These teams include physicians, nurse practitioners, nurses, social workers, dietitians, health promoters, early childhood educators, counsellors and others. SWCHC is sponsored and managed by an incorporated non-profit community board made up of members of our community. SWCHC is well known for its excellent community health centre model and its professional health services team, but it has also become a leader in offering a wide range of social services, community-building activities and advocacy programs….more

In September 2014, Canada’s Community Health Centres adopted anational members resolution re-committing to the critical role of Community Health Centres in increasing democratic engagement across Canada. Research demonstrates that there are tangible mental and physical health benefits associated with participation in democratic discourse and processes, including voting…..more