A conceptual framework to guide public oral health planning in Limpopo province

Background: There is limited understanding of the complexities surrounding public oral health service delivery in South Africa and the resulting impact on oral health outcomes. Aim: This study aimed to identify the strengths and challenges in oral health decision-making within the public health sector and to propose a conceptual framework to guide oral health service delivery in the province. Setting: This study was performed in the Limpopo province. Methods: National and provincial health policy documents were reviewed to identify statements on oral health service delivery. A face-to-face, semi-structured interview was conducted with the Limpopo Provincial Manager of Department of Health, Oral Health Services. Data were collected on oral health policies and the organisational structure of public oral health services. A self-administered questionnaire was completed by five district managers of public oral health services to obtain data on the delivery of public oral health services in Limpopo province. Results: The results indicated that oral healthcare was not explicitly mentioned, included or referred to in the examined health policy documents. The interviews indicated that public oral health services do not have a dedicated budget and were not considered a priority. The questionnaire results revealed challenges in infrastructure, human resources and perceived marginalisation from the healthcare services. Participants agreed that there was a need for oral health to be clearly expressed and prioritised in health policy statements. Conclusion: This study proposed a framework that incorporated the identified core components that influenced oral health services provision in Limpopo province

The impact of MLA-NG conference attendance on medical librarians in Nigeria

This study investigated the impact of the Medical Library Association of Nigeria (MLA-NG) conference attendance on medical librarians in Nigeria. The study employed survey design method and questionnaire was used for the data collection. The data obtained were analyzed using tables, frequency distribution, percentages and charts. The findings of the study revealed that majority of the respondents mentioned that they have attended the conference about twice or more and affirmed that the conferences attended have to a 'great extent' impacted on them. The findings also revealed that the benefits derived from attending conference include: update on current trends in librarianship, opportunity to learn new skills, networking and socializing with librarians from other libraries. Despite the benefits of attending conference, it was observed that the major constraints to conference attendance include: lack of sponsorship, high cost of registration for participants, lack of awareness of the conference among others. The study therefore, recommended that heads of medical libraries should consciously set certain amount aside in their institutions' library budget for conference sponsorship to ease cost of conference attendance for their staff. Also, organizers of conferences should also publicize schedules in good time using effective means of communication that can easily reach their members. Keywords: Conference; Medical Librarians, Professional development; Medical Library Association of Nigeria

Demand for Programs for Key Populations in Africa from Countries Receiving International Donor Assistance

There has been increasing attention in recent years to the HIV prevention; treatment; and care needs of key populations in Africa; in particular men who have sex with men (MSM); injection drug users (IDU); and female sex workers (FSW). While several major donors have undertaken efforts to prioritize these groups; it remains unclear which African countries are actively seeking donor support for these programs. For this analysis; we reviewed publicly available proposal and budget documentation from the US PEPFAR for fiscal years 2007 through 2010 and Rounds 1 through 10 of the Global Fund to Fight AIDS; Tuberculosis and Malaria for 40 countries in sub-Saharan Africa. Of the 164 searchable documents retrieved; nearly two-thirds contained at least one program serving FSW (65; 107 proposals); less than one-third contained at least one program serving MSM (29; 47 proposals); and a minority proposed programming for IDU (13; 21 proposals). Demand for these programs was highly concentrated in a subset of countries. Epidemiological data for at least one key population was included in a majority of these proposals (63; 67 proposals); but in many cases these data were not linked to programs

Doctors' Use of Laboratory Tests in the Diagnosis and Treatment of Patients

Abstract:The provincial health budgets in South Africa are under enormous pressure and; annually; budgets are exceeded by most hospitals and clinics. Laboratory tests requested by clinicians are contributing to the problem of over-expenditure. The aim of this study was to determine from patients' files whether doctors were using laboratory tests prudently during their treatment of patients in the outpatient department (OPD) of the National District Hospital in Bloemfontein. A descriptive study was carried out using all the files of patients who visited the OPD in a three-month period (1 July to 30 September 2005) for whom laboratory tests were requested by the attending physician. The majority (31.3) of patients for whom laboratory tests were requested presented to the OPD with cardiovascular complaints or diagnoses; followed by endocrine (27.8) and musculoskeletal (16.3) complaints or diagnoses. Between one and three tests were requested for most patients; i.e. 33 and 15; respectively. The most frequently requested tests were erythrocyte sedimentation rate (8.1); urea and electrolytes (7.7); urine microscopy; culture and sensitivity (6.4); cholesterol (6.1); full blood count (5.7) and thyroid profile (TSH 4.6; T4 2.6 and thyroid functions 2.3). In 70.4 of cases; results were documented and; in 59.1; the physician's management plans indicated the incorporation of laboratory test results into the patient's treatment regimen. Our findings indicated inappropriate documentation and application of test results. Interventions to improve physician behaviour include education; guidelines; feedback; leadership and redesign of requisition forms

Delivering on a Gendered Definition of Health Needs in Local Government Budgeting: Experiences and Concepts

Background: Local governments are granted budgetary power in the Local Governments Act of the Republic of Uganda2; which allows for local-level participation and flexibility in the allocation of financial grants channelled annually from central to local governments. The act prescribes a legal mandate to allocate public resources based on local priorities including the health needs of women compared with men. This study investigated the responsiveness of local government budgeting to the health needs of women as compared to men.Methodology: A qualitative study was conducted in Mpigi district using a set of data collection methods including: a) three (3) focus group discussions with 8 female and 8 male respondents in each group; b) face-to-face interviews with a random sample of 120 households; 75of which were male-headed and 25female-headed ; c) key informant interviews with a sample of 10 administrative officers in Mpigi district ; and d) desk-review of the Mpigi district Budget Framework Paper 4. Results: Health needs consist of the daily requirements; which; arise out of common disease infections and the socio-economic constraints that affect the well-being of women and men. However; the primary concern of the district health sector is disease control measures; without emphasis on the differing socio-economic interests of women as compared to men. Local government budgeting; therefore; does not reflect the broad community-wide understanding of health needs. Conclusion: Local government budgeting should be informed by a two-fold framework for the gendered definition of health needs. The two-fold framework combines both disease-based health needs and socio-economic needs of women as compared to men

Proposed programme budget 1992-1993 : fortieth session of the Regional Committee [for Africa]; Brazzaville; September 1990

The document consists of six main parts. Like the previous Programme Budget; the presentation in this document shows the country programmes immediately after introduction. This confirms the importance attributed to the country programmes as the main focus of activities. This WHO/AFRO Proposed Programme Budget for 1992-1993 is the second presented in the framework of the Eighth General Programme of work covering the specific period 1990-1995