Publications

Au Mali, les indicateurs de santé restent préoccupants. Une meilleure performance du secteur public dans la fourniture de services de base est une nécessité absolue pour la réduction de la pauvreté. Le défi posé aux divers acteurs en matière de santé communale est de travailler ensemble de façon effective au profit d’une santé publique appropriée aux besoins locaux, y compris à ceux des groupes les plus vulnérables.

Although agricultural research and development (R&D) in West Africa aim at improving the livelihoods of resource-poor farmers, the intended beneficiaries are often too poorly organised and consequently have limited political clout to influence the R&D agenda. The authors are not aware of farmers in West Africa funding agricultural R&D projects; this in contrast to farmers in Northern America and Europe

Since the early 1990s, several studies have looked at the impact of HIV/AIDS and household responses, mainly in East and Southern African countries where HIV infection has reached rates in excess of 30% of adult populations (Kwaramba, 1998; Rugalema, 1999; Luzobe, Muheewa, Olaunah, Wandui, & Kalenzi, 2001; Shah, Osborne, Mbilizi & Vilili, 2002; Muwanga, 2002; Booyens & Arntz, 2003; SADC-FANR, 2003; Yamano and Jayne, 2004). These studies concluded that AIDS has a disproportionate impact on the morbidity and mortality of the most productive age groups. Its impact on households is characterised by a sharp reduction in the available time, labour and other resources of individuals and households, even leading to loss of assets. Because the disease has both a long incubation period and is accompanied by a lengthy period of illness, the socio-economic as well as
psychological impact will be felt over a prolonged period. In addition to the suffering this causes, the increase in AIDS prevalence adversely affects individual lives as well as state development and efforts to alleviate poverty. In West Africa, the HIV/AIDS epidemic developed at a slower pace but infection rates are rising fast. Because countries have their own unique contexts, it cannot be assumed that the findings of East and Southern African studies on the impact of the epidemic can be extrapolated and used in a straightforward way to develop policy in other region

Considerable effort has been made to estimate the global resource requirements of scaling-up HIV/AIDS and tuberculosis (TB) interventions. There are currently several medium- and long-term global estimates available. Comprehensive country specific estimates are now urgently needed to ensure the successful scaling-up of these services. This paper reviews evidence on the global resource requirements of scaling-up HIV/AIDS and TB interventions. The purpose of this review is to summarise and critically appraise the methods used in the global estimates and to identify remaining knowledge gaps, particularly those relevant to country level estimation.

A motivated and qualified workforce is crucial to increase the productivity and quality of health services in order to contribute to achieving health services targets. Priority programmes have a stake in a skilled and motivated workforce, as they are implemented primarily by a health facility’s existing health staff. Motivation in the work context is defined as “an individual’s degree of willingness to exert and maintain an effort towards organisational goals”. The challenge for managers is how to create this kind of motivation. Research has shown that workers and their managers often perceive motivation differently. In addition, little is known about the motivational factors that are important for health workers in resource-poor settings.

Around 1.5 million people die every year of malaria; every 30 seconds a child dies due to this preventable and curable disease. Over 90 % of malaria cases and the great majority of malaria deaths occur in sub-Saharan Africa. Most of the affordable antimalaria drugs have become ineffective because Plasmodium falciparum – the malarial parasite responsible for the most severe malaria cases and deaths – has developed resistance to them.

Ten years after the International Conference on Population and Development (ICPD), it is relevant and necessary to review and reflect on progressmade in implementing a more holistic and comprehensive view of reproductive health care, as called for in the ICPD Programme of Action. In
1994, the international health community agreed on the need to integrate sexual and reproductive health care services to meet the needs of women,
men and adolescents throughout the life-cycle. Integration was seen to provide the best hope and means for quality, comprehensive and cost-effective service delivery. Since that time, however, efforts to integrate services have produced mixed results, and there is now a need to take stock of accomplishments and to suggest where further efforts are needed if countries are to provide quality, comprehensive sexual and reproductive
health care.

Agriculture and rural development are – at least partly – back on the international development agenda. Investments in agricultural and rural development are important ingredients in policies for fostering broad-based and pro-poor economic development in countries where more than half – and often close to 75 per cent – of the population still mainly depend on agriculture for their livelihoods. Rural areas harbour 75 per cent of the poor, who are desperately seeking ways to improve their living conditions and income

Agricultural development aimed at poverty reduction in Sub-Saharan Africa (SSA) requires greatly accelerated technological, organizational and institutional innovation. Emphasis on strengthening the demand side for agricultural service provision and the call for a separation of responsibilities for policy making, funding and implementation have resulted in alternative funding mechanisms for agricultural research and development (R&D) at national and local levels.

Millions of smallholder farmers and indigenous communities in Africa are
working to improve their livelihoods in an environment characterized by
dwindling government support and increased competition between producers, processing companies and supermarkets within agricultural markets. How can we assist smallholders to cope with these challenges and secure market access and better incomes? What strategies can NGOs and business development services adopt to support this type of farmers?

The medicinal plant sector in Uttaranchal, a Himalayan state in northern India, can provide an important source of income to the rural population, especially as returns from traditional crops are declining (Alam 2003). Because of its diverse agroclimatic conditions and relative isolation, India’s Himalayan region is richly endowed with a large variety of plant species, many of which have medicinal properties. The medicinal plants found in the Himalayan areas include species of particularly high medicinal value (Planning Commission 2000). People in India have long known of the benefits of medicinal and aromatic plants, which provide raw materials for both the pharmaceutical industry and traditional forms of medicine. Besides providing basic health care, the plants generate income and employment and also have implications for the preservation of biodiversity and of traditional knowledge

In 1995, Novib and a number of its partners initiated a courageous and risky journey; they undertook a collective learning and organisational change process to promote gender equality within their organisations. The programme was called the Gender Focus Programme. The Politics of the Possible is the story of the journey undertaken by seven NGO partners of Novib in South Asia and the Middle East. Today, a decade after the Beijing conference in 1995, it is hard to imagine that the process of gender mainstreaming and organisational change was uncharted territory when the GFP began. Thus the seven participating organisations, whose endeavours are the focus of this book, had to find their way using no more than an organisational development tool adapted for the programme.

Since the 1990s Sub-Saharan African countries have embarked on major
agricultural sector reforms, which led to changing and innovative roles for the public and private sectors as well as civil society organizations. Farmers’ organizations (FOs) now increasingly voice the needs of their members in various fora on policy-making and orienting service provision. They are solicited by the private sector to enhance chain development, including those for new markets, and they play a role in local development planning. FOs are now, more than ever, actively involved in agricultural development, which requires institutional, organizational and technological innovation in order to be successful. Providing user-oriented research, extension, and training services is therefore a prerequisite for technological innovation. Institutionalizing participatory methods, decentralizing services, creating multi-actor platforms and multi-stakeholder driven funding mechanisms all enhance demand-driven agricultural services. The private-sector and/or public-private arrangements currently play an increasing role in research and extension. FOs are thus evolving in an environment where stakeholders’ interests diverge and/or converge. However, the effective use of new technologies to become innovations is often defined by conditions other than simple access to knowledge and information; it often requires appropriate, innovative institutional and organizational settings. The agricultural innovation systems concept therefore considers links between actors, interactive learning processes, and the policy and institutional contexts that govern the system in order to better understand the generation, dissemination and application of knowledge. The agricultural innovation systems concept also emphasizes the need for all stakeholders to work together towards innovation for development

Worldwide, the choice of consumer products is increasing rapidly. One of the effects of economic liberalization is more international trade, so consumers are presented with new products and many more brands. How do they respond to this mushrooming number of products? If we can compare a modern supermarket with a dense tropical forest, how does a consumer find the right plant species that is safe and tasty? Do we need Neanderthal-like skills to fill our shopping carts with the right ingredients to feed our families?

The growing strength of the women’s movement in the 1960s and 1970s challenged the ‘medicalization’ of women’s bodies and the medical construction of woman’s health needs as distinct from women’s own experiences and priorities (Boston Women’s Health Book Collective 1992). The women’s movement questioned the fallacy that males, as doctors or partners, knew better or more about women’s bodies than women did. Women articulated felt experiences of mental, physical, reproductive and sexual health needs. Analysing their experiences with reference to the social, political and economic forces that shaped health, women explored the connections between race, class and gender based oppression as they affected the health of women.

The devastating impact of AIDS in the world – especially in sub‐Saharan Africa ‐ has led to an unprecedented global effort to ensure access to antiretroviral (ARV) medicines to treat the disease in every country where HIV is a threat. While the World Health Organization (WHO) goal of ensuring access to antiretroviral treatment (ART) for 3 million people by end‐2005 was not achieved, an estimated 1.3 million people who would not otherwise have been treated now have access to ART. This book is a
testament to the early treatment successes and the hidden challenges of antiretroviral therapy (ART) in resource‐poor settings. It is also a wake‐up call to the risk of treatment failure and the development of widespread ARV resistance unless all patients are given the continuing support they need to achieve full adherence to ARVs. AIDS is particularly challenging because of the need to achieve very high (at least 95%) levels of adherence to prevent treatment failure and the generation of ARV‐resistant virus.

The Women Centered Health Project was an experiment to operionalise the principles of the 1994 International Conference on Population and Development. The project was aimed at improving the provision of women centered reproductive and sexual health services through the Municipal Corporation of Greater Mumbai.