The Equity and Access Sub Group; Current Achievements of the Future Challenges in Promoting Equity in the Health Sector in Malawi

This paper first sets the context for the Equity and Access Sub-Group (EetASG) by describing the move towards Sector Wide Approaches (SWAps). SWAps are a new concept through which the Ministry of Health is delivering services through mechanisms of basket funding and decentralization of services once delivered by vertical programmes to districts. SWAps present new opportunities of enhancing equity and access to services for all groups in Malawi. Opportunities for achieving this lies within a constitution of new partnerships for the advocacy and monitoring of the performance of the health sector in meeting the needs of different social and economic groups. These new partnerships include the Health Sector Review Group; Monitoring and Evaluation Research Technical Working Group and the Equity and Access Sub-Group (EetASG). This paper describes the EetASG; a good example of these new partnerships. The memberships and terms of reference of this group are described

Framework for Monitoring Equity in Access and Health Systems Issues in ART Programmes in Southern Africa

Universal provision of antiretroviral therapy (ART); while feasible; is expensive. In light of this limitation; the World Health Organisation (WHO) has launched the 3 x 5 initiative; to provide ART to 3 million people by the end of the year 2005. In Southern Africa; large-scale provision of ART will likely be achieved through fragile public health systems. ART programmes should therefore be developed and expanded in ways that will not aggravate inequities or result in the inappropriate withdrawal of resources from other health interventions or from other parts of the health system. This paper; proposes a framework for monitoring equity in access and health systems issues in ART programmes in Southern Africa. It proposes that an equity monitoring system should comprise seven thematic areas. These thematic areas encompass a national monitoring system which extends beyond one agency or single data collection method. Together with monitoring of targets in terms of numbers treated; there should also be monitoring of health systems impacts and issues in ART expansion; with reporting both nationally and to a regional body

Geographical Information Systems in TB control

Geographical Information Systems (GIS) is becoming a useful tool in disease control by health planners. However little is known about its potential in tuberculosis (TB) control. In 2000 the National TB Programme (NTP) in Malawi assessed its usefulness. Routinely collected case-finding data from the 3 previous years (1997 to 1999) were entered into a system containing a digital map of Malawi. District performance was mapped. We concluded that GIS may be complementary in monitoring TB programme performance; and may be useful for target setting; advocacy; and research. World Health Organisation (WHO) now provides free GIS software (Health Mapper) and training. However; the use of GIS in TB control still needs further piloting and expansion without constraining the locally available resources or disrupting the present TB data management system