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Archive for September 20th, 2012

The man who admitted in a Nairobi court he is Al-Shabaab member is jailed for 59 years

Posted by African Press International on September 20, 2012

Good for Kenya or not? have your say!

Nairobi Chief Magistrate Lucy Nyambura has jailed for a Somali man for 59 years. The man had earlier admitted to being a member of Al Shabaab during his first court appearance. The Magistrate convicted Abdimajid Yasin Mohamed alias Hussein after the accused pleaded guilty to nine out of 10 counts.

When the suspect appeared in court last week, charged alongside Abdi Adan alias Salman Abdi he arrogantly pleaded guilty while his accomplish denied the charges.

The accused’s behaviour in court gave the magistrate not choice but to order him to undergo psychiatric examination. The doctors gave him a clean bill – that he was sane to stand trial.

When brought to court Thursday, he maintained he was guilty and asked the magistrate to allow him to serve his sentence inside Somalia so that he could be near his wife and children.

The two men, when they were arrested in Nairobi’s Eastleigh area, were in a possession of bombs, grenades and a cache of weapons. It included 480 bullets, six suicide bombs,  four AK 47 rifles, and 12 grenades..

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Global South leads the way towards universal healthcare coverage

Posted by African Press International on September 20, 2012

JOHANNESBURG,  – An increasing number of developing countries are introducing universal healthcare coverage – and creating new models to do it – according to research published in The Lancet. Lessons learned from countries like Ghana, India and Rwanda are already shaping the way countries like South Africa are beginning to pilot their own bids for universal coverage.

In the early 20th century, two models of universal healthcare coverage emerged in the United Kingdom and Germany. The UK uses general taxes to fund publicly provided healthcare in its one risk pool model, while Germany’s multiple risk pool model relies on household premiums and payroll taxes, and relies on private healthcare providers. Industrialized countries like Japan, Canada and France have all implemented variations of these two models.

But countries from the global South are creating their own models, according to research by the Results for Development Institute and others, published in The Lancet as part of its universal healthcare coverage series.

The research, which surveyed nine developing countries in Africa and Asia (which are now part of a joint learning network on the issue) found that the new models vary considerably but have several common characteristics, including increased revenue and health budgets, larger risk pools and use of the private sector.

The rationale for moving to universal healthcare is also largely the same, according to lead author Gina Lagomarsino, a managing director at the Results for Development Institute. “In most cases, the move to universal coverage is a response to people feeling like they’re paying too much out of pocket for healthcare that they can’t afford or can’t even get because it’s too expensive,” she told IRIN/PlusNews.

Finding the funds

Nigeria used revenue freed up by debt relief to fund pilot universal coverage programmes for expecting mothers and children, while Ghana increased value-added taxes by about 3 percent in 2003 to fund its programme. Ghanaian policy makers noted that earmarking the increase for health expenditures made it an easier sell to voters.

“For Ghana, it became a major issue in the [2004] elections,” Lagomarsino said. “People were tired of what, in Ghana, had come to be known as the ‘cash and carry’ system of healthcare where people had to pay a lot out of pocket, so it became very political to create a system where everyone could have access.”

On average, countries had to increase government spending on health by as much as 11 percent to fund universal coverage efforts. Only in the Philippines did the government decrease spending, according to the research.

International aid accounted for more than a quarter of funding in only three countries – Mali, Kenya and Rwanda – where almost half of universal healthcare coverage was donor-funded, according to the research.

However, authors in an accompanying paper caution that increases in revenue have to be accompanied by better governance and population targeting to make a real difference.

Bigger pools and the public-private mix

While two-thirds of countries surveyed had multiple risk pools, which some argue foster inequality and increase administration costs, researchers found many countries were consolidating these pools into larger ones.

“Successful countries have been moving towards broader, larger risk pools where you have more of the population under one system rather than a fragmented one that, for instance, has separated pools for civil servants, the formal sector, the poor,” Lagomarsino said.

“Bringing everyone into one pool can make healthcare more equitable because everyone is entitled to the same set of benefits.”

''For Ghana it became a major issue in the [2004] elections. People were tired of what, in Ghana, had come to be known as the ‘cash and carry’ system of healthcare where people had to pay a lot out of pocket, so it became very political to create a system where everyone could have access''

Most countries are also choosing to include the private sector. Of the nine countries surveyed, only Rwanda and Vietnam rely solely on public health providers. The majority of countries surveyed purchase health services from public and private service providers, allowing for varying degrees of patient choice in providers. Most reliant on the private sector is federalist India, where private health insurers bid to implement state health coverage. These companies are then tasked with enrolling people in healthcare plans, receiving state money based on the number of people enrolled.

According to Lagomarsino, advocates of the controversial system argue that because companies are paid per enrolled member, they are motivated to reach out to the previously uninsured in poor and rural communities. Detractors argue that it may also create a perverse incentive to poorly educate people on the package of services they are entitled to, ensuring that services remain underutilized and that companies’ payments to healthcare providers are limited.

Lagomarsino and her co-authors warn against the total exclusion of the private sector insurance in universal healthcare coverage, arguing that this can lead to two-tiered systems, in which poor people go to public facilities perceived to be of lower quality and those who can pay use private care. A mixed public-private system, by contrast, can use subsidies or other mechanisms to extend private care to the poor.

Although not included in the study, South Africa provides one of the world’s best examples of such a two-tiered system, Lagomarsino told IRIN/PlusNews. According to the Democratic Nursing Organisation of South Africa, 8.1 million South Africans pay to utilize the better resourced private sector while about 41 million rely solely on the public healthcare system in which some treatments, like renal dialysis, are rationed.

Brian Ruff, CEO of South Africa’s largest private health insurance, Discovery Health, co-authored a commentary on inequalities in South Africa’s health system in 2011. In it, he and his co-authors characterized the health system as deeply divided, with stark and growing differences in access and quality between public and private care – mirroring the inequalities between rich and poor in almost every aspect of South African life.

South Africa latest to join expanding club

But measures are underway to change this. Shortly after his 2009 inauguration as South African Health Minister, Aaron Motsoaledi began to move the country toward universal healthcare coverage through a national health insurance (NHI), convening a ministerial advisory committee of health experts on the matter. In 2011, the country issued its first draft policy document on the NHI, and in April 2012 launched the initiative in ten pilot districts nationally. While these pilot sites have been funded through a conditional grant, the NHI will eventually be funded through a dedicated fund.

South Africa’s Treasury Department had promised to release a policy paper in April of this year, outlining how the NHI would be funded, but it has yet to do so. In this paper’s absence, speculation remains rife as to how the government will fund its move to universal coverage.

llg/kn/rz source



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The “unfinished business” of lowering child mortality

Posted by African Press International on September 20, 2012

The vast majority of child deaths are preventable (file photo)

NAIROBI,  – In 1990, an estimated 12 million children around the world died under age five; by 2011, that figure had dropped to 6.9 million. The message, from a new report by the UN Children’s Fund (UNICEF), is that with greater commitment to child survival from governments and their partners, these figures can go lower still.

“These new data are cause to celebrate,” UNICEF deputy executive director Geeta Rao Gupta said at a press conference launching the2012 Progress Report on Committing to Child Survival: A Promise Renewed. “But this is unfinished business, and it is not just about numbers. Behind every statistic is an unseen child, and a grieving mother and father.”

The vast majority of child deaths are preventable. Almost two-thirds of under-five deaths in 2011 were caused by infectious illnesses such as pneumonia, diarrhoea, malaria, meningitis, tetanus, HIV and measles; by contrast, in countries with very low under-five mortality rates, there were almost no deaths from infectious diseases. More than one-third of under-five deaths could be attributed to undernutrition, and almost 40 percent occurred within the first month of life, often due to preterm or delivery complications.

According to the report, nine low-income countries – Bangladesh, Cambodia, Ethiopia, Liberia, Madagascar, Malawi, Nepal, Niger and Rwanda – have lowered their under-five mortality rate by 60 percent or more over the last two decades. These countries used simple, tried and tested methods to improve child survival: widespread immunization campaigns for diseases like measles and polio; insecticide-treated mosquito nets to prevent malaria; interventions ranging from folic acid supplements to clean delivery practices to improve newborn survival; and exclusive breastfeeding to address undernutrition.

The global drop in under-five mortality works out to a decline of about 3 percent per year, but if the world is to meet theMillennium Development Goals on child mortality and maternal health, child deaths need to fall by 14 percent per year, according to the World Health Organization.

Poorest go without

Under-five deaths are largely concentrated in sub-Saharan Africa, which accounted for almost half of these deaths in 2011, and South Asia, where 33 percent of under-five deaths occurred. In a few instances – Burkina Faso, Chad, Cameroon, the Democratic Republic of Congo, Mali and Somalia – under-five mortality actually rose between 1990 and 2011.

The report also noted wide disparities within countries. Data from 39 countries show that children born into the poorest fifth of a population are almost twice as likely to die before age five as those born into the wealthiest fifth. Other factors that increase risk of under-five death include: being born in rural areas; being born to mothers without basic education; and living in areas affected by violence and political fragility.

Many of the simplest interventions remain inaccessible in impoverished parts of Africa and Asia. For instance, globally, less than one-third of children with diarrhoea receive oral rehydration salts.

In Uganda, which has registered a 49 percent decline in under-five mortality since 1990, health workers say the cost of vaccines remains a major hindrance, and the country’s overburdened health system is struggling to cope with the needs of one of the world’s fastest growing populations.

“We have some vaccines which have reduced illness among the children, like pneumococcal and rotavirus, which are not wildly available in health units due to high cost,” Jolly Natukunda, a senior paediatric consultant at Mulago National Referral Hospital, Uganda’s largest referral facility, told IRIN.

But according to Mickey Chopra, UNICEF’s chief of health, the price of many vaccines has fallen significantly in recent years through negotiations between the GAVI Alliance and manufacturers and suppliers of vaccines. In 2011, pharmaceutical giant Pfizer cut the price of its pneumococcal vaccine – which prevents pneumonia, meningitis and sepsis – by more than 50 percent for developing countries, which now spend just US$3.50 per dose.

A pledge to do more

In June, UNICEF and its partners launched A Promise Renewed, a global effort to reenergize the improvement of maternal, newborn and child survival. Since its inception, more than 110 governments have signed a pledge vowing to redouble efforts to reduce child mortality. The movement aims to rapidly decrease under-five mortality by improving countries’ evidence-based plans; strengthening accountability for maternal and child healthcare; and mobilizing support for the principle that “no child should die from preventable causes”. It aims to prioritize the world’s poorest people.

“A child’s death is all the more tragic when caused by a disease that can easily be prevented. That’s why we have this global movement to recommit to child survival and renew the promise to end child deaths. This decline shows we can make this happen,” UNICEF’s Rao said.

kr/so/rz source



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