Publications

Community health workers (CHWs) have a unique position between communities and the health sector. The strength of CHWs’ relationships with both sides influences their motivation and performance. This qualitative comparative study aimed at understanding similarities and differences in how relationships between CHWs, communities and the health sector were shaped in different Sub-Saharan African settings. 

Iran has enjoyed a universal coverage of primary healthcare services since 1990s, due to the effective health system structure. However, chronic maldistribution of secondary care services and hospital beds compounded with financial barriers to such services have been a continuing challenge. As a consequence of the “Universal Health Insurance Act” in 1994, several initiatives have been conducted to increase population coverage and/or financial protection from healthcare costs. As a result, Iran’s population benefits from a high healthcare insurance coverage, estimated at about 83% of the population in 2010. It is now believed that over 95% of the population is under one sort of health insurance coverage as a result of an ambitious health transformation plan starting in 2014.

This publication outlines an alternative route to achieving sustainable economic development and food security in developing areas. Rather than on high-value, niche export markets for tropical products which attract a lot of attention, we want to focus on local and regional commodity markets. It is our intention to show how important these markets are for smallholders, and how vibrant and well-functioning markets can improve food security for both smallholder families and consumers at the regional and national level. Through several illustrative cases, this book highlights how various organisations are working to improve smallholder access to local and regional markets. They seek to realise this by helping farmers achieve higher productivity and production volumes as well as by working to improve marketing and provide stable economic development based on local conditions. The stories of small-scale producers are embedded in a theoretical framework, and by combining theoretical analysis and practical know-how, we aim to demonstrate the real potential of these ‘regional markets’ for promoting sustainable economic development and food security.

In recent years, social protection has climbed up the policy agenda as a major policy response to chronic poverty and vulnerability with positive impacts on food security, income and access to basic services. In SubSaharan Africa, persistent levels of poverty and inequality, unemployment and underemployment, and a high degree of labour market informality have encouraged governments to adopt social protection as a key instrument for achieving inclusive development (Miroro, 2015). Its ability to achieve inclusive development is largely due to its catalytic role in redistribution and potential to reach the poorest (Ministry of Foreign Affairs, 2015; Olivier, 2013). Inclusive development here is defined as a ‘pattern and pace in which the poor and most vulnerable groups participate and which is characterised by income growth, increase of productive employment as well as decreasing inequality in both income and non-income dimensions of wellbeing’ (NWO, 2014).

In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of
India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those
mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction.

Cet ouvrage se propose de mettre en exergue la contribution du pastoralisme au développement économique de l’Afrique de l’Ouest à travers la valorisation d’initiatives locales et des résultats de recherches. Ces exemples illustrent la capacité du pastoralisme, et des chaînes de valeur1 qui en découlent, à s’adapter à une demande croissante et de plus en plus exigeante pour des produits d’origine animale. Les propos mettent en lumière les défis à relever pour accompagner ces mutations et fournissent des argumentaires pour réconcilier la pratique et la politique afin que celle-ci devienne un véritable instrument au service du développement des communautés et des systèmes pastoraux.

KIT is proud to launch a new 4 part analysis of maize seed systems – in Malawi, Zambia, Bihar in India and Chiapas in Mexico. These studies show that the maize seed sectors in these areas are quite advanced, although need better quality controls. At all 4 places hybrid varieties are now widely grown by small farmers, although in Chiapas, Malawi and Zambia local varieties remain popular for local food preparation. The studies were carried out with support from the CGIAR Research Program (CRP) MAIZE. Please find all the reports below:

For many decades, the Netherlands Society for Tropical Medicine and International Health (NVTG) has provided training in the Netherlands to doctors aspiring to work in low- and middle-income countries. Over the years, the training has professionalized, resulting in the formal recognition, in 2012, of the ‘doctor International Health and Tropical Medicine’ (doctor IHTM) as a medical specialization, by the Dutch Royal Medical Association (KNMG). In addition, the Commission for the Registration of Medical Specialists (RGS) recognized the Institute of International Health and Tropical Medicine (IGT), which oversees the implementation of the post-graduate specialization programme. This commission extended IGT’s accreditation up to 2021. However, the approval was not unconditional and stipulated modernization and an overhaul of the curriculum to better
align it with the training programme.

In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births

Knowledge of risk factors and their relative importance in different settings is essential to develop effective health education material for the prevention of typhoid. In this study, we examine the effect of household level and individual behavioural risk factors on the risk of typhoid in three Indonesian islands (Sulawesi, Kalimantan and Papua) in the Eastern Indonesian archipelago encompassing rural, peri-urban and urban areas.

The recent thematic series on close-to-community providers published in this journal brings together 14 papers from a variety of contexts and that use a range of research methods. The series clearly illustrates the renewed emphasis and excitement about the potential of close-to-community (CTC) providers in realising universal health coverage and supporting the sustainable development goals. This editorial discusses key themes that have emerged from this rich and varied set of papers and reflect on the implications for evidence-based programming. We are at a critical stage in the development of CTC programming and policy which requires the creation and communication of new knowledge to ensure the safety, sustainability, quality and accessibility of services, and their links with both the broader health system and the communities that CTCs serve.

The evaluation provided an independent assessment of UNFPA interventions in the area of family planning and identified key lessons learned for the current and future strategies. The particular emphasis of this evaluation was on learning with a view to informing the implementation of the UNFPA family planning strategy Choices not chance 2012-2020, as well as other related interventions and programmes, such as the Global Programme to Enhance Reproductive Health Commodity Security (GPRHCS- 2013-2020). The results of the evaluation have informed the midterm review of the UNFPA 2014-2017 Strategic Plan.

Routine HIV screening of prisoners is generally recommended, but rarely implemented in low-resource settings. Targeted screening can be used as an alternative. Both strategies may provide an opportunity to start HIV treatment but no formal comparisons have been done of these two strategies. The paper aims to discuss these issues.

Background In India, the poor are increasingly forced to live in highly populated urban dwellings with inadequate living conditions including deficient service provision. This in turn affects their food security and negatively influences their health. In December 2012, Dilli Annashree Yojna (DAS), an unconditional cash transfer scheme was launched for the urban poor in Delhi to address food security and, ultimately, nutrition and health. Our study attempts to explore DAS for new elements like unconditionality and transfer to female head of family, use of benefits, operational issues and perceptions on its influence on health.

Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff.

The WHO has approved a post-2015 Global End Tuberculosis Strategy for tuberculosis (TB) 50 prevention, care and control. Countries need to respond by adapting and enhancing their TB control activities. Justifying investment in effective TB control strategies in a country can be achieved in part by defining and monitoring the (MDR) TB epidemic to identify appropriate interventions.