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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

The price of exclusion : the economic consequences of excluding people with disabilities from the world of work

BUCKUP, Sebastian
2009

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People with disabilities can work and contribute to the economy, just like people without disabilities. This report highlights the macro-economic cost of excluding people with disabilities from the labour market. The study quantifies the economic losses of ten countries in Asia and Africa and presents the outcomes. It would be useful to people interested economic and employment issues for people with disabilities

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

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

Addressing violence against women in HIV testing and counselling

WORLD HEALTH ORGANIZATION (WHO)
2006

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This is a summary and recommendations from an international consultation co-convened by the WHO departments of Gender, Women and Health (GWH) and of HIV & AIDS to identify and review promising strategies or good practices to support women who may fear or experience violence as a consequence of HIV testing and/or HIV status disclosure; and develop recommendations to guide programmes and policies related to HIV testing and counselling, in light of current strategies to expand access to these and related services

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

WHO’s multi-country study on women’s health and domestic violence against women : summary report of initial results on prevalence, health outcomes and women's responses

WORLD HEALTH ORGANIZATION (WHO)
2005

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"Violence against women by an intimate partner is a major contributor to the ill-health of women. This study analyses data from 10 countries and sheds new light on the prevalence of violence against women in countries where few data were previously available. It also uncovers the forms and patterns of this violence across different countries and cultures, documenting the consequences of violence for women’s health. This information has important implications for prevention, care and mitigation... The high rates documented by the Study of sexual abuse experienced by girls and women are of great concern, especially in light of the HIV epidemic. Greater public awareness of this problem is needed and a strong public health response that focuses on preventing such violence from occurring in the first place...This study will help national authorities to design policies and programmes that begin to deal with the problem"

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

Disability and rehabilitation status : review of disability issues and rehabilitation services in 29 African countries

GIANNELLLI, Massimo
DEEPAK, Sunil
Eds
December 2004

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This report provides information related to disability issues and rehabilitation services, provided by 29 countries of Africa, and includes demographics, the presence of national policies and NGOs. The report is divided into the following three parts: a global review of information, the country profiles and a summary table of the information provided in individual countries. This report is useful for people interested in disability and rehabilitation services in Africa

Processes and issues for improving access to medicines : willingness and ability to utilise TRIPS flexibilities in non-producing countries

BAKER, Brook K.
August 2004

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This paper addresses the varied ways by which a non-medicine producing country may lawfully utilise the agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) flexibilities, primarily by importing. However, it also briefly discusses means for promoting local production through pharmaceutical capacity building and through both compulsory and voluntary licensing. To help decision-makers in understanding and evaluating the opportunities and constraints of each alternative, the paper briefly describes their respective advantages and disadvantages in terms of developing countries’ sustainable access to more affordable medicines, highlighting differing legal interpretations, political realities and pragmatic administrative and economic constraints

People with disabilities in crisis response

INTERNATIONAL LABOUR ORGANIZATION (ILO)
May 2003

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The ILO's InFocus programme on crisis response and reconstruction has focused particularly on disabled ex-combatants in a number of countries including Afghanistan, Angola, Cambodia, Ethiopia, Mozambique and Namibia. Projects in these countries have assisted governments, agencies, local NGOs and organisations of persons with disabilities to provide vocational skills training, mostly in mainstream vocational training centres but also in special rehabilitation centres

Best practices on indigenous knowledge

UNITED NATIONS EDUCATION SCIENCE AND CULTURE ORGANIZATION (UNESCO). Management of Social Transformations Programme (MOST)
NETHERLANDS ORGANIZATION FOR INTERNATIONAL COOPERATION IN HIGHER EDUCATION. Centre for International Research and Advisory Networks (NUFFIC/CIRAN)
Eds
1999

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This publication provides a series of case studies to illustrate how indigenous knowledge (IK) can be used to create sustainable development. It aims to suggest, by example, guidelines for development planning, as the practices described may give policy makers and development practitioners a deeper insight into the ecological and cultural complexity of sustainable development. Includes basic definition of IK and related terms, and indexes by country and theme

The Africa campaign on disability and HIV & AIDS

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The Africa Campaign is a unifying umbrella under which disabled people's organisations, organisations of people living with HIV & AIDS, non-governmental organisations, AIDS services organisations, researchers, activists, and other citizens work collectively to achieve two main objectives: a coordinated response involving persons with disabilities in African countries to achieve inclusive national HIV & AIDS policies and programmes; and equal access for persons with disabilities in Africa to information and services on HIV & AIDS. This website contains information about the campaign and key documents

African Palliative Care Association

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Palliative care is seen as a vital component in the care of people with progressive, life-limiting illnesses (including HIV/AIDS). The Africa Palliative Care Association works to promote and support affordable and culturally appropriate palliative care throughout Africa, including to orphans and vulnerable children.
A pan-African organisation ensuring that palliative care is widely understood, integrated into health systems at all levels and underpinned by evidence in order to reduce pain and suffering across Africa

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