COVID-19: an opportunity for African governments to rethink social welfare benefits and protection

The emergence of COVID-19 in December 2019 has highlighted several lessons about Public health emergencies. One important lesson is on the role of social welfare benefits and protection in the overall management of public health emergencies. The absence of a functional and digitalized social welfare system in Africa may render ineffective public health measures to mitigate the spread of COVID-19. The social determinant of disease illustrates the nexus between poverty and health outcomes. Therefore, COVID-19 is an opportunity for African governments to rethink their stance on social welfare benefits and protection; and adopt mechanisms that protect the most vulnerable

The demographic transition in the Democratic Republic of Congo: facts and challenges to reach a demographic dividend

Background: The channels linking the demographic and economic situation of a population are numerous. We focus on the process of a demographic transition and the demographic dividend that Sub-Saharan Africa and, in particular, the Democratic Republic of Congo (DRC), are currently undergoing. Data source and methods: Secondary data are used to highlight the diverse paths of demographic transition in Sub-Saharan African countries. Additionally, the specific situation of the DRC is selected as a case study. Results: The potential of Sub-Saharan Africa to enjoy a demographic dividend is exceptional. Although the DRC is in the group of the least advanced countries, its increasing share of working age population is a key to reap the benefits of the potential economic growth. Conclusion: There are some recent economic and social advancements in the DRC, but the benefits of its demographic performance are dependent on whether government and institutions are capable of responding to current circumstances with targeted, effective and coordinated policies

Urgences et médecine de catastrophe

La concentration humaine et urbaine, le développement des technologies , les menaces de destruction et de contamination sont à l'origine d'une prise de conscience de la nécessité d'une assistance civile. L'aide médicale urgente, qui s'affirme et s'oriente vers une médecine de réseau, en partenariat avec toutes les structures concourant à l'urgence, participe à la rationalisation de la politique sociale. Les acteurs de l'aide médicale urgente contribuent ainsi à sauvegarder, tout en l'améliorant, un secteur sanitaire et social qui est désormais l'un des fondements de la démocratie et l'une de ses assises face aux défis du futur

Boni Mores and Consent for Child Research in South Africa

Consent is required for almost all health research. In order for consent to be valid a number of requirements must be met including that the consent cannot be contra bonos mores or contrary to public policy. This principle has its roots in the common law and it is used to ensure that the consent to harm; or the risk of harm; is permitted or ought to be permitted by the legal order. Recently; it has also become a statutory requirement embedded in the consent obligations relating to non-therapeutic health research with minors. Section 71 of the National Health Act provides that the Minister of Health (or potentially his or her delegated authority) must provide consent to non-therapeutic research with minors. However; such consent may not be granted if 'the reasons for the consent to the research or experimentation are contrary to public policy'. Limited work has been done on how to determine when consent to health research with children would be contrary to public policy. This article attempts to begin the debate by describing the boni mores principle; setting out some of the general factors that could be used to assess whether consent is consistent with it and suggesting how they could be applied to health research.The article concludes by stating that simply requiring proxy consent for non-therapeutic health research with children is insufficient as it cannot always be assumed that proxy consenters will act in the best interests of the child. Thus the boni mores principle acts as a limit on autonomy in order to protect the child participant. It is further submitted that establishing when consent to health research is consistent with public policy requires an assessment of whether the research is consistent with constitutional values; prevailing legal norms regarding children; and an assessment of the legal convictions of the community

Reading the National Disability and Rehabilitation Policy in the light of Foucault's technologies of power

In the area of disability studies, models have been at the centre of debates, influencing social policies, practices and legal frameworks. The former Ministry of Health and Social Welfare in the Kingdom of Lesotho was not an exception. In its efforts to tackle issues of disability, it produced The National Disability and Rehabilitation Policy: Mainstreaming persons with disabilities into society in 2011. This policy document is rooted in the social model and seeks to address long-standing problems and challenges of people with disabilities in the Kingdom. Using ideas from Foucault, particularly the technologies and regimes of power, which work through language and practice, this article examined ways in which people with disabilities are constituted through state knowledge and government policies, and concluded that these constructions form the basis for alienation and marginalisation in society

School Managers' Understanding of HIV/AIDS in Gauteng; South Africa

This paper presents the diverse understandings of HIV/AIDS and people living with HIV (PLHIV) revealed by school managers in a selection of public schools in Gauteng Province; South Africa. Discussions with school managers emerged as part of a larger investigation into the interplay of culture and gender in people's experience of HIV. The respondents from five public schools comprised head teachers; school board members; educators and adult learners. The data were assembled from semi-structured interviews; focus group discussions; comments on rumours and gossip; and informal conversations. Mary Douglas's (1966) analysis of the theory of cultural risk has provided the main approach for explaining the prevailing understandings of HIV and AIDS among the South African educators. Despite good knowledge of HIV and AIDS; the respondents' understanding of the disease and the experiences of PLHIV were commonly drawn from six categories of meaning: biomedical; cultural; religious; witchcraft; race; and eschatology. Social constructs were strong in terms of the ways HIV/AIDS and PLHIV were understood in these South African education workplaces. The findings imply that new strategies are required from the government and agencies that are involved in developing responses to the HIV epidemic; especially in the education sector

From HIV Prevention to Reproductive Health Choices: HIV/AIDS Treatment Guidelines for Women of Reproductive Age

In South Africa; the private sector has responded to the HIV epidemic by providing treatment in the form of highly active antiretroviral therapy (HAART). The private sector has paved the way for policy and treatment regimens; while the public sector has reviewed health-systems capacity and the political will to provide treatment. The paradigm of prevention of mother-to-child transmission of HIV (PMTCT) has led the way as a clear evidenced-based method of treatment and prevention in South Africa. In sub-Saharan Africa; the HIV epidemic is feminised as a growing proportion of infections occurs among women or affects women. While access to HIV treatment has been contested in South Africa; women's sexual and reproductive health has been neglected. This paper is a reflection and critical review of current practice. Many HIV-positive women desire to choose to have a child; while the best choice of contraception for women on HAART is not well understood. In some areas there are reports of women being forced to accept injectable contraceptives. Some women who learn of their HIV-positive status during pregnancy may want to choose to terminate their pregnancy. There is a clear absence of HIV/AIDS-treatment guidelines for women of reproductive age; including options for HAART and options regarding fertility intentions. A range of other sexual and reproductive health areas (relevant to both the public and private health sectors) are neglected; these include depression and anxiety; violence against women; HIV-testing practices; screening for cervical cancer; and vaccination. Given the narrow focus of HAART; it is important to expand HIV treatment conceptually; by applying a broader view of the needs of working women (and men); and so contribute to better HIV prevention and treatment practices. There is a need to move from an HIV/AIDS-care maternal-health paradigm to one that embraces women's sexual and reproductive health and rights

Infecondite et politique de population en Afrique Centrale

L'Afrique Centrale reste sur le continent la zone la plus affectee par le phenomene de l'infertilite et de la sous-fecondite. Et malgre l'absence de series chronologiques sur la fecondite; les etudes s'accordent pour reconnaitre une evolution variable de l'infecondite; avec une tendance a la baisse dans la plupart des pays de la region. Les consequences de l'infecondite au plan individuel comme au plan collectif sont multiples. Elle a d'importantes implications politiques et socio-economiques