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Beneath the rhetoric: Policy to reduce the mental health treatment gap in Africa

COOPER, Sara
2015

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In this paper I problematize knowledge on reducing the ‘gap’ in treatment produced by 14 national mental health policies in Africa. To contextualize this analysis, I begin with a historic-political account of the emergence of the notion of primary health care and its entanglement within decolonization forces of the 1960s. I unpack how and why this concept was subsequently atrophied, being stripped of its more revolutionary sentiments from the 1980s. Against this backdrop, I show how, although the 14 national mental health policies are saturated with the rhetoric of primary health care and associated concepts of community participation and ownership, in practice they tend to marginalize local meaning-systems and endorse a top-down framework heavily informed by colonial medicine. The policies thus end up reproducing many of the very Eurocentric assumptions that the original primary health care notion sought to transcend. More specifically, the paradigms of evidence-based research/practice and individualised human rights become the gatekeepers of knowledge. These two paradigms, which are deeply embedded within contemporary global mental health discourse, are legislating what are legitimate forms of knowing, and by extension, valid forms of care. I argue that a greater appreciation of the primary health care concept, in its earliest formulation, offers a potentially fruitful terrain of engagement for developing more contextually-embedded and epistemologically appropriate mental health policies in Africa. This in turn might help reduce the current ‘gap’ in mental health care treatment so many countries on the continent face.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

Documenting good practices at partner level

MUTUVI, Kavutha
MAINA, Gacheru
LACKEY, Douglas
2011

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This report documents the good practices of HelpAge and its partners while implementing a regional advocacy programme to mitigate the impact of HIV and AIDS among older people in six sub-Saharan African countries. It presents information about what is working and not working in different situations and contexts by highlighting and documenting the lessons learned and the process of what works, how and why. This resource is useful for anyone interested in the impact of HIV and AIDS among older people in Africa

The IMF, the global crisis and human resources for health : still constraining policy space

LEFRANÇOIS, Fabien
February 2010

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This report "...examines evidence from nine IMF country programmes, chosen based on their HIV prevalence rates, and finds that although the IMF has changed its tune and is talking about greater flexibility, these changes are not enough and are only temporary. "In 2006, the World Health Organisation (WHO) estimated that 57 countries were facing a severe health workforce crisis.... Addressing this shortage, and action alongside it to strengthen health systems around the world, requires substantial, concerted effort from both aid donors and recipient governments. The current global downturn threatens to undermine steps taken in this direction so far and jeopardise progress towards the health-related Millennium Development Goals. "...the IMF has adapted its rhetoric so that it now claims its programmes are more flexible on fiscal and monetary policies, which determine to what extent governments can maintain or increase spending - including of foreign aid - and stimulate economic activity"

National response to disability and HIV in Eastern and Southern Africa

HANASS-HANCOCK, Jill
GRANT, Kitty
February 2010

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Although people with disabilities are often at increased risk of exposure to HIV, this policy brief outlines that less than half of the national strategic plans in Eastern and Southern Africa recognise disability as an issue of concern. Recommendations are provided to governments and civil society on how to address the issue effectively. This policy brief would be useful to people interested in HIV policies in Africa

Disability in national strategic plans on HIV and AIDS : a review on the national response to the interrelations of disability and HIV in eastern and southern Africa|Final report

GRANT, Kitty
STRODE, Ann
HANNASS-HANCOCK, Jill
December 2009

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This report examines national AIDS and HIV strategic plans (NSPs) in eastern and southern Africa and includes findings, discussions and best practice examples on the integration of disability throughout the countries. "Generally, the findings of the report show that less than 50% of the countries in Eastern and Southern Africa recognise disability as an issue of concern, or specifically recognise the vulnerability of people with disabilities to HIV and AIDS within their NSPs. Furthermore, it found that even where countries have recognised disability as an issue, there is limited specific guidance within the NSP on HIV-related service provision to meet the needs of people with disabilities. Only one country, South Africa, showed extensive integration of disability into the various focus areas of its NSP." The report concludes with recommendations and provides detailed appendices of national reports for each country surveyed

Integrating multiple gender strategies to improve HIV and AIDS interventions : a compendium of programs in Africa

INTERNATIONAL CENTER FOR RESEARCH ON WOMEN
May 2009

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This report looks at how four specific gender strategies are being used in HIV and AIDS intervention programmes, how they are working, and how people are learning from and sharing their experiences toward strengthening programmes and expanding successes. A number of programmes in 11 African countries, as well as multi-country programmes are examined. The four gender strategies are: - Reducing gender-based violence; - Increasing women‘s legal protection; - Addressing male norms and behaviours, and - Strategies to increase women‘s income and productive resources.

The health worker shortage in Africa : are enough physicians and nurses being trained?

KINFU, Yohannes
et al
February 2009

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"The health worker shortage in sub-Saharan Africa derives from many causes, yet the dynamics of entry into and exit from the health workforce in many of these countries remain poorly understood. This limits the capacity of national governments and their international development partners to design and implement appropriate intervention programmes. This paper provides some of this information through the first systematic estimates of health worker inflow and outflow in selected sub-Saharan African countries"

Inspiring futures : learning from memory work in Africa

DUNN, Alison
HAMMOND WARD, Sarah
2009

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This learning paper looks at the experiences of applying memory work as part of broader strategies to mitigate the impact of HIV and AIDS in five African countries. It explores how six NGOs in sub-Saharan Africa established memory work as a key component of their community-based HIV programmes and draws on the experience of people living with HIV and AIDS, children and young people who participated in the initiative, partner organisations' own learning and analysis and the end of project evaluation report

Supporting HIV-positive teachers in East and Southern Africa

MALLOURIS, Chrstoforos
BOLER, Tania
September 2007

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This report provides an overview of the impact of HIV on teachers and the specific issues HIV-positive teachers face. It also summarises support mechanisms for teachers with HIV and presents key conclusions and recommendations from the consultation regarding how the education sector can support HIV-positive teachers. The report is the result of a consultation involving a range of different stakeholders including representatives of Ministries of Education, teachers' unions and HIV-positive teachers' networks from six countries in East and Southern Africa

HIV/AIDS communication in selected African countries : interventions, reponses and possibilities

PARKER, Warren
RAU, Asta
PEPPA, Penny
2007

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This review looks at communication activities around HIV prevention in 11 countires in South and East Africa operating in 2006 at a national level. It considers the variations in HIV epidemiology between countries, and the heterogeneity within them, and examines the different approaches to communication that are used. The country summaries include a synopsis of the epidemiology, indicators of knowledge, behaviour and service uptake and information about HIV and AIDS prevention communication, activities, approaches and funding

Pain relieving drugs in 12 African PEPFAR countries : mapping current providers, identifying current challenges, and enabling expansion of pain control provision in the management of HIV/AIDS

HARDING, Richard
et al
January 2007

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This study aims to identify current opioid prescribing services and regulatory bodies within 12 African PEPFAR (Presidents Emergency Plan for AIDS Relief ) countries, and to examine the barriers to, and appraise the potential for, expansion in the number of opioid providers, for people with HIV and AIDS according to the World Health Organization pain ladder. It concludes that while there are common issues raised by services and International Narcotics Control Board competent authorities, it is clear that these key stakeholders have concerns regarding the potential roll-out of opioids

Tell me more : children's rights and sexuality in the context of HIV/AIDS in Africa

THOMSEN, Sarah C
2007

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This report explores the strategies that children have developed for dealing with sexuality and relationships in the face of HIV and AIDS; and provides stakeholders with a coherent rights and youth-oriented knowledge base for the development of a sexual and reproductive health agenda for advocacy. It gives an overview of sexual rights with a focus on children’s rights, including their access to sexual and reproductive health information, as endorsed by relevant international conventions and policies. It also looks at the concept of sexuality and the sexual development of children. The report includes a summary of children’s reflections on issues of sexuality and their coping mechanisms for preventing the transmission of HIV and AIDS. Based on these findings, the report makes recommendations for effective responses that would support children’s existing coping mechanisms and enhance their ability to protect themselves

Social protection : how important are the national plans of action for orphans and vulnerable children?

SABATES-WHEELER, Rachel
PELHAM, Lissa
October 2006

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This is a review of 14 national plans of action (NPA), or in the absence of a NPA, outputs from the rapid assessment analysis and action planning (RAAAP) work for orphans and children made vulnerable by HIV/AIDS. It analyses the way that issues of social protection are incorporated into these plans and highlights areas within the plans where social protection activity may be needed to achieve stated outcomes. There are also country by country summaries of the social protection content of each NPA

CSO capacity for policy engagement : lessons learned from the CSPP consultations in Africa, Asia and Latin America

CHOWDHURY, Naved
FINLAY-NOTMAN, Chelsie
HOVLAND, Ignie
August 2006

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This paper explore the views of Southern civil society organisations (CSOs) on the issues of evidence-based policy engagement and came out of the Civil Society Partnerships Programme (CSPP). "During its first phase the CSPP conducted a series of consultative seminars and workshops in Africa, Asia and Latin America. The aim was to provide a forum for representatives from policy research institutions and non-governmental organisations (NGOs), as well as other stakeholders, to come together. Participants discussed the opportunities and challenges for CSOs when using evidence to inform policy, presented lessons and best practice in this area, shared experiences about ongoing activities and identified opportunities for collaborative work"

Civil society involvement in rapid assessment, analysis and action planning (RAAAP) for orphans and vulnerable children : an independent review

GOSLING, Louisa
July 2005

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This review explores civil society organisations' experiences of the Rapid Assessement, Analysis and Action Planning (RAAAP) process - an initiative launched by USAID, UNICEF, UNAIDS, and the World Food Program - for orphans and other vulnerable children in November 2003. It comprises of a review of where civil society organisations were involved and where they were not and an overview of the process of their invovlement. It also offers recommendations for existing and future RAAAPs to ensure greater invovlement of civil society organisations, and includes individual reports on the 16 sub-Saharan African countries invovled in the first round of RAAAP in 2004

USAID project profiles : children affected by HIV/AIDS

UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
January 2005

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This document presents profiles of 114 projects (90 country-specific, 12 regional, and 12 global) funded by USAID. It includes a section on USAID projects that support access to education in Africa. The project profiles include the names of implementing organisations, funding periods and amounts, objectives, strategies, key accomplishments, priority activities for the year ahead, and materials and tools available to other projects that can help meet the needs of children and youth affected by HIV and AIDS. The diversity of these projects demonstrates the US government's efforts to meet the wide variety of needs of children and youth affected by HIV and AIDS. Approaches vary in both strategy and scale. The vast majority of projects work with communities to identify opportunities that strengthen existing resources without undermining local ownership. In many places, communities are already mobilised and have systems in place to identify, protect, and provide basic necessities to the most vulnerable children. USAID supports the strengthening and monitoring of these existing activities

Mapping malaria risk in Africa

MAPPING MALARIA RISK IN AFRICA / ATLAS DU RISKE DE LA MALARIA EN AFRIQUE (MARA/ARMA)
December 2004

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This site presents maps of malaria risk and endemicity (the presence of malaria) in Africa, drawing on published and unpublished data, and through spatial modelling of malaria distribution, seasonality and endemicity. Many factors, especially endemicity, affect the choice of control methods. In the absence of such data it is impossible to rationalize the allocation of limited resources for malaria control. This site presents an opportunity to rethink endemicity and how we may map malaria risk in order to better support planning and programming of malaria control

The use of information and communication technologies (ICTs) in African public library services

ROSENBURG, Diana
July 2004

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This article concerns the use of computers in public libraries in developing countries. To investigate the current level of use of ICTs and plans for the future within the public library environment, a survey was undertaken of 22 public library services in ten English-speaking African countries. The results indicate great disparities in the level of access to computers between the countries, and within country, and indicate a need for more funding and appropriate training

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