Publications

The conference ‘Governing for Equity’ was the outcome of a process in which many individuals and institutions have been involved over a period of three years beginning in 1999. In that year KIT Gender, at the Royal Tropical Institute in Amsterdam, initiated a three-year programme entitled ‘Gender, Citizenship and Governance’.

A landlocked Sahelian country, Burkina Faso has an estimated population of
around 12 million inhabitants and covers 274 000 km2. Its location presents considerable challenges for the economic development of the country. The climate can be classified as Sudanese, with two contrasting seasons, a rainy and a dry season lengthening into the more northern reaches of Burkina. Rainfall varies from one year to another and droughts can take a heavy toll on agricultural production, which is the mainstay of the Burkinabé economy.

Many Ministries of Health are trying to improve the functioning of their health care system by introducing changes in resource allocation, better management and changes in the role of the government, such as more responsibility at lower levels through decentralisation. A prerequisite of a well-functioning system is a well-motivated workforce. The Ministry of Health in Viet Nam gives great importance to the development of a public health network, in order to provide good quality health care services. As most people live in rural areas, an extensive public health network is required in rural areas so as to provide appropriate care close to the people. This implies the need to keep sufficient qualified and motivated human resources in the rural areas.

Over the past several years the HIV/AIDS pandemic in Africa has been recognized as being more than simply a health issue. HIV/AIDS impacts every sector, including education. In the high HIV-prevalence countries of southern and eastern Africa, the education sector is currently being hit by massive teacher shortages due to death, absenteeism, and attrition as teachers fall ill, care for sick family members, or fill vacancies in other fields. At the same time, the needs of learners are changing as young people must learn at an earlier age how to protect themselves from HIV/AIDS and care for affected family members and friends.

Mainstreaming a gender perspective in development was the overall strategy adopted at the Fourth UN Conference for Women, held in Beijing in 1995, to support the goal of gender equality. The rationale for this strategy is that it is important to bring the goal of gender equality to the centre of the development process. After three decades of gender and development activism, most in development institutions continue to need constant reminders of the need for gender analysis in their work. Why is it that policy makers still have to be lobbied to include the g word, and colleagues need to be convinced that integrating a gender analysis in their work makes a qualitative difference?

Agricultural research and extension in sub-Sahara Africa have been subject to repeated organisational and institutional reforms during the last few decades. Donors and central governments were the main drivers of reorganisation and re-structuring processes. Mostly “blueprints” based on “western” models were applied; although sometimes a perceived lack of impact was given as the rationale, the actual reasons for change were often of an ambiguous nature.

Au cours des dernières décennies, la recherche et la vulgarisation agricole en Afrique subsaharienne ont connu d’importantes réformes institutionnelles et organisationnelles. Les bailleurs de fonds et les Gouvernements nationaux étaient les principales forces de réorganisation et de restructuration.

A literature review was conducted to review work done to date on measuring stigma related to leprosy. References were obtained through a PubMed (Medline) search and through examining relevant bibliographies. Twelve papers were selected that addressed the issue of measurement of stigma and that contained a sample of the instrument used. Three unpublished studies were also included in the review

This study was designed to investigate whether leprosy patients diagnosed with mild sensory impairment have a better prognosis when treated with steroids than similarly impaired patients treated with placebo.

A ‘disability classification’ for use in leprosy has been advocated by who since 1960. Two revisions of this grading system were subsequently published, a 4-point scale in 1970 and a 3-point scale in 1988.

Reactions in leprosy patients causing acute nerve function impairment (NFI) can often be treated successfully with corticosteriods. Treatment with corticosteriods in leprosy control programmes is increasingly being provided under field conditions, often by paramedical workers.

Nerve Function Impairment (NFI) in leprosy patients may lead to severe disabilities, such as muscle paralysis of face, hands and feet, and chronic plantar and palmar ulceration. For many years, the mainstay of treatment of NFI of less than 6 months duration, in particular in the presence of clinically manifest type 1 reaction, has been with corticosteriods. For NFI of longer than 6 months duration, however, this treatment is not recommended. Beyond 6 months of NFI, never fibres are considered to be damaged irreversibly, and are therefore unlikely to respond to treatment. Yet there are indications that some patients with long-standing NFI have responded favourably to treatment with corticosteriods.

Over the past decades the number of new leprosy patients detected worldwide has been more or less stable (WHO, 2002). In 2001 more than 750,000 new patients were diagnosed (WHO, 2002). It is very likely that a significant number of new patients will continue to occur for many years. Hence, leprosy control activities should be sustained, and to guarantee sustainable leprosy services they should be integrated within the general health services (ILA, 2002).

Every year, over half a million new leprosy are detected. Since there is no evidence that the transmission in high endemic countries has been substantially interrupted, it is expected that in the coming years considerable numbers of leprosy patients will continue to report to health facilities.