DOCSLIB.ORG

The Right to Health, Health Systems Development and Public Health Policy Challenges in Chad Jacquineau Azétsop1* and Michael Ochieng2

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Right to Health, Health Systems Development and Public Health Policy Challenges in Chad Jacquineau Azétsop1* and Michael Ochieng2 Azétsop and Ochieng Philosophy, Ethics, and Humanities in Medicine (2015) 10:1 DOI 10.1186/s13010-015-0023-z RESEARCH Open Access The right to health, health systems development and public health policy challenges in Chad Jacquineau Azétsop1* and Michael Ochieng2 Abstract Background: There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. Method: This paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14. Results: The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions. Conclusion: The normative ideals of health systems development are essentially democratic in nature and are rooted in human rights and in ethical principles of human dignity, equality, non-discrimination and social justice. These ideals are grounded in an integrated vision of society as a place for multi-level interactions, where government plays its role by equitably providing institutions and services that ensure people’s welfare. Inter-sectoral collaboration, which calls for a conceptual shift in health and public policy, can be instrumental in improving health systems through concerted efforts of various governmental institutions and civil society. Keywords: The right to health, Health systems development, Social justice, Health policy, Intersectoral collaboration, Public health and democratic governance, Community agency, Social participation, Accountability and transparency * Correspondence: [email protected] 1Département de Santé Publique, Faculté des Sciences de la Santé de l’Université de N’djaména, Avenue Mobutu, BP 1117, N’ djaména, Tchad Full list of author information is available at the end of the article © 2015 Azétsop and Ochieng; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Azétsop and Ochieng Philosophy, Ethics, and Humanities in Medicine (2015) 10:1 Page 2 of 14 Introduction Institut National de la Statistique, des Etudes Economi- In common with most modern human rights, the right to ques et Démographiques (INSEED), Ministry of Economy health (RH) is comprehensive and morally compelling, for and Agence Française de Cooperation to analyze critically it does not simply uncover empirical facts of systemic vio- the shape and performance of health systems (HS) in lations of human dignity but points to the messiness of Chad. As hermeneutical tools, this critical analysis uses the sociopolitical arena and establishes the normative obli- key concepts and components of the right to health gations of the institutional bodies that have the human contained in article 12 of the International Covenant on rights responsibility to protect population health. Properly Economic, Social and Cultural Rights and in General understood, the RH has a profound contribution to make Comment 14. From Article 12, the performance of health toward building healthy societies and equitable HS. This systems are evaluated on four main points: the state of in- right is grounded in a broad definition of health as “astate fant and maternal health, environmental conditions, dis- of complete physical, social and mental well-being, and ease prevention and access to primary care. From General not merely the absence of disease or infirmity” [1]. Health Comment 14, the paper derives the core obligations of the is regarded by the World Health Organization (WHO) as state and criteria for evaluating the progressive realization a fundamental human right and, correspondingly, WHO of the RH by state’s institutions. The paper strategically holds that all people should have access to basic resources uses the right-to-health analysis of HS, an element of the for health. Health is a resource which allows people to entire social system, to point out important values and lead a productive life because its acquisition conditions ac- policies that may improve the responsiveness of the cess to many goods. Hence, “Arguments to do with a right healthcare system to people’sneeds. to health are therefore concerned with claims to live in a physical and social environment that does not prejudice the prospects for leading a full and healthy life, including The right to health in international primary healthcare access to health services” [2]. These arguments raise con- and human rights documents cern about the justice of social institutions in providing The recognition of the RH prescribed by the Universal access to healthcare to all and ensuring people’swell- Declaration of Health (UDHR) in 1948 was further con- being. The goals of the RH are congruent with those of firmed by the 1978 Alma-Ata Declaration on primary health systems development (HSD), which is about health care (PHC) and subsequent PHC documents. Health strengthening health promotion organizations and actions promotion, one of the fundamental aspects of PHC, has so as to improve public health. been addressed by the Ottawa Charter (1986) and subse- The normative ideals of HSD are essentially demo- quent health promotion documents from Adelaide (1988), cratic, rooted in human rights and ethical principles of Sundsvall (1991), Jakarta (1997), Mexico (2000), Bangkok human dignity, equality, non-discrimination and social (2005) and Nairobi (2009). The RH is also recognized in justice. These democratic ideals are partly prompted by major human rights instruments, including the UDHR (Art the inclusiveness of the RH, which presupposes an un- 25 (1)), the 1965 International Convention on the Elimin- derstanding of health as a good connected to other so- ation of All Forms of Racial Discrimination (art. 5), ratified cial goods. Our approach to the justice of HSD will by the Republic of Chad in August 1997; the 1966 Inter- logically demand equity in all the domains that interface national Covenant on Economic, Social and Cultural Rights with human health. This approach to justice is rooted in (art. 12), ratified in June 1995; the 1979 Convention on the an integrated vision of society as a place for multi-level in- Elimination of All Forms of Discrimination Against teractions, where government plays its welfare-enhancing Women (arts. 11 (1) (f), 12 and 14 (2) (b)), ratified in June role through an equity-based provision of public services 1995; the 1989 Convention on the Rights of the Child (art. and dimensions of well-being [3]. Inter-sectoral collabor- 23, 24), ratified in September 1990; the 1990 International ation is a way to implement our approach to health just- Convention on the Protection of the Rights of All Migrant ice. It calls for a conceptual shift in health and public Workers and Members of Their Families (arts. 28, 43 (e) policy. Inter-sectoral collaboration offers a good prospect and 45 (c)), signed in September 2012; and the 2006 Con- for an integrated response to well-being issues by the gov- vention on the Rights of Persons with Disabilities (art. 25), ernment. Democratic transparency, accountability and signed in September 2012. Numerous conferences and subsidiarity are important groundings for ensuring the declarations endorsed by the Republic of Chad, such as the public’s participation in society’s affairs and monitoring International Conference on PHC, the United Nations the performance of public institutions. Millennium Declaration and Millennium Development Goals and the Declaration of Commitment on HIV/AIDS Method have also helped clarify various aspects of public health This paper uses a secondary data analysis of existing docu- relevant to the RH and have reaffirmed commitments to its ments on HS by the Ministry of Public Health (MPH), realization. The RH is also recognized in the African Azétsop and Ochieng Philosophy, Ethics, and
Load more

Recommended publications
  • Health Care Services
    Document of The World Bank FOR OFFICIAL USE ONLY Public Disclosure Authorized Report No: PAD885 INTERNATIONAL DEVELOPMENT ASSOCIATION PROJECT APPRAISAL DOCUMENT ON A PROPOSED GRANT Public Disclosure Authorized IN THE AMOUNT OF SDR 10.22 MILLION (US$15.79 MILLION EQUIVALENT) AND A PROPOSED GRANT IN THE AMOUNT OF US$5 MILLION FROM THE MULTI-DONOR TRUST FUND FOR HEALTH RESULTS INNOVATION Public Disclosure Authorized TO THE REPUBLIC OF CHAD FOR A MOTHER AND CHILD HEALTH SERVICES STRENGTHENING PROJECT May 6, 2014 Health, Nutrition and Population (AFTHW) Country Department West Africa (AFCW3) Public Disclosure Authorized This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization. CURRENCY EQUIVALENTS (Exchange Rate Effective March 31, 2014) Currency Unit = Franc CFA (FCFA) XAF 475.38 = US$1 US$1.55 = SDR 1 FISCAL YEAR January 1 – December 31 ABBREVIATIONS AND ACRONYMS AF Additional Financing AIDS Acquired Immuno-Deficiency Syndrome AFTEM Africa Region Financial Management Unit ANC Ante-Natal Care ARI Acute Respiratory Infection CAS Country Assistance Strategy CBO Community-based Organizations CFAF Central African Franc CHW Community Health Worker CPA Central Pharmaceutical Purchasing Agency CPA Complementary Package of Actions CPAR Country Procurement Assessment Report CPIA Country Policy and Institutional Assessment CPS Country Partnership Strategy CSO Civil Society Organization DALY Disability-Adjusted
    [Show full text]
  • Design and Implementation of Health Information Systems
    Design and implementation of health information systems Edited by Theo Lippeveld Director of Health Information Systems, John Snow Inc., Boston, MA, USA Rainer Sauerborn Director of the Department of Tropical Hygiene and Public Health, University of Heidelberg, Germany Claude Bodart Project Director, German Development Cooperation, Manila, Philippines World Health Organization Geneva 2000 WHO Library Cataloguing in Publication Data Design and implementation of health information systems I edited by Theo Lippeveld, Rainer Sauerborn, Claude Bodart. 1.1nformation systems-organization and administration 2.Data collection-methods I.Lippeveld, Theo II.Sauerborn, Rainer III.Bodart, Claude ISBN 92 4 1561998 (NLM classification: WA 62.5) The World Health Organization welcomes requests for permission to reproduce or translate its pub­ lications, in part or in full. Applications and enquiries should be addressed to the Office of Publi­ cations, World Health Organization, Geneva, Switzerland, which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. © World Health Organization 2000 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Or­ ganization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]
  • Factors Determining Water Treatment Behavior for the Prevention of Cholera in Chad
    Am. J. Trop. Med. Hyg., 93(1), 2015, pp. 57–65 doi:10.4269/ajtmh.14-0613 Copyright © 2015 by The American Society of Tropical Medicine and Hygiene Factors Determining Water Treatment Behavior for the Prevention of Cholera in Chad Jonathan Lilje,* Hamit Kessely, and Hans-Joachim Mosler Eawag: Swiss Federal Institute of Aquatic Science and Technology, Du¨bendorf, Switzerland; Centre de Support en Sante´ Internationale (CSSI), N’Djamena, Chad Abstract. Cholera is a well-known and feared disease in developing countries, and is linked to high rates of morbidity and mortality. Contaminated drinking water and the lack of sufficient treatment are two of the key causes of high transmission rates. This article presents a representative health survey performed in Chad to inform future intervention strategies in the prevention and control of cholera. To identify critical psychological factors for behavior change, structured household interviews were administered to N = 1,017 primary caregivers, assessing their thoughts and attitudes toward household water treatment according to the Risk, Attitude, Norm, Ability, and Self-regulation model. The intervention potential for each factor was estimated by analyzing differences in means between groups of current performers and nonperformers of water treatment. Personal risk evaluation for diarrheal diseases and particularly for cholera was very low among the study population. Likewise, the perception of social norms was found to be rather unfavorable for water treatment behaviors. In addition, self-reported ability estimates (self-efficacy) revealed some poten- tial for intervention. A mass radio campaign is proposed, using information and normative behavior change techniques, in combination with community meetings focused on targeting abilities and personal commitment to water treatment.
    [Show full text]
  • The Relationships Between Livestock and Human Wealth
    THE RELATIONSHIPS BETWEEN LIVESTOCK AND HUMAN WEALTH, HEALTH, AND WELLBEING IN A RURAL MAASAI COMMUNITY OF SOUTH- WESTERN KENYA by Catherine Sian Glass B.Sc., The University of British Columbia, 1986 M.Sc., The University of Toronto, 1993 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) October 2019 © Catherine Sian Glass, 2019 The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: The relationships between livestock and human wealth, health, and wellbeing in a rural Maasai community of South-Western Kenya submitted by Catherine S. Glass in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Population and Public Health Examining Committee: Dr. Trevor Dummer, School of Population and Public Health Supervisor Dr Monika Naus, School of Population and Public Health Supervisory Committee Member Dr Jerry Spiegel, School of Population and Public Health University Examiner Dr David Fraser, Land and Food Systems University Examiner Dr Guy Palmer, Washington State University External Examiner Additional Supervisory Committee Member: Dr. Marina Von Keyserlingk, Land and Food Systems ii Abstract Livestock are critical to the livelihood of up to two billion global poor and thus represent an ideal focus for poverty amelioration. For traditional keepers, livestock are: culturally significant, nutritionally important, and serve as “daily currency” and household “savings”. However, they may also increase infectious disease risk, especially via zoonoses which can reduce both human and livestock health and quality of life.
    [Show full text]
  • Country Progress Report 2006 Chad
    Chad_UNGASS Report_2005 Unity - Work - Progress REPUBLIC OF CHAD **** MINISTRY OF PUBLIC HEALTH **** General Secretariat **** National Report on the UNGASS Indicators CHAD 2005 December 2005 1 Chad_UNGASS Report_2005 INDEX Page INTRODUCTION------------------------------------------------------------------------------------ 1.1. Report framework --------------------------------------------------------------------------------------- 1.2. Report objectives -------------------------------------------------------------------------------------- I. NATIONAL COMMITMENT ------------------------------------------------------------------ 1.1. Government national funding for HIV/AIDS ------------------------------------------------------ 1.2. Strategic plan ----------------------------------------------------------------------------------------------- 1.3. Political support ------------------------------------------------------------------------------------------- 1.4. Prevention -------------------------------------------------------------------------------------------------- 1.5. Care and support ------------------------------------------------------------------------------------------ 1.6. Human rights ---------------------------------------------------------------------------------------------- 1.7. Civil society involvement -------------------------------------------------------------------------------- 1.8. Monitoring and evaluation ------------------------------------------------------------------------------- 1.10. Life-skills-based HIV/AIDS
    [Show full text]
  • The State of Maternal and Infant Health and Mortality in Chad DOI: 10.29063/Ajrh2020/V24i1.4
    Obiang-Obounou and Fuh Maternal and Infant Mortality in Chad ORIGINAL RESEARCH ARTICLE The State of Maternal and Infant Health and Mortality in Chad DOI: 10.29063/ajrh2020/v24i1.4 Brice Wilfried Obiang-Obounou1* and Manka Eunice Fuh2 Department of Food Science and Nutrition, Keimyung University, Daegu, South Korea1; Department of Public 2 Policy and Administration, Yeungnam University, Daegu, Korea *For Correspondence: Email: [email protected]; Phone: +82-53-580-5870 Abstract The level of Chad‘s government expenditure on health is a predictor of the general health of the population and, consequently, life expectancy. We used data from the World Bank‘s World Development Indicators and publications from the World Health Organization to assess the state of maternal and infant health and mortality. The primary objective of this research was to investigate whether Chad had reduced the risk of maternal and infant mortality after signing the Abuja Declaration in 2001. We hypothesised that increased general government health expenditure was associated with improved health mediated by increased numbers of skill health workers and minimum out-of-pocket health expenditure. Our secondary objective was to assess effective implementations of health policies in line with the Millennium Development Goals that Chad has agreed to achieve by 2015. We observed that, as of 2015, the government health expenditure was only 6.28% and the population out-of-pocket spending was over 56%. Furthermore, only 20% of women give birth in a hospital. These results led to three major policies recommendations in order to improve maternal and infant health in Chad: skilled birth attendants training, enhanced social status of nurses, and the development of a supplemental nutrition care program for women.
    [Show full text]
  • Final UNICEF Newsletter On
    POLIO-FREE CHAD UNICEF QUARTERLY ON THE POLIO ERADICATION INITIATIVE IN CHAD October 2013 A Year Without WPV How to dismantle a hard-hitting enemy Frontline Focus Working with nomads along migration routes & photo essay Keeping cVDPV in-check Intensifying mop-up campaigns 1 © UNICEF NYHQ/2012/Holt A Year Without WPV WITH THE CONTRIBUTION OF Eradicating WPV is an ambitious BRUNO MAES Representative endeavour. In a country where MARCEL S. OUATTARA the public health system is still in Salamat Forum Deputy Representative need of a major push, this result A regional forum in the district GIANLUCA FLAMIGNI Chief, Polio is of significant importance, and of Am-Tinam brought together LALAINA FATRATRA ANDRIAMASINORO gives hope for making a polio- political, administrative, Chief of Communication free world a reality. traditional and religious leaders DJINGRI OUOBA in aims of establishing a network C4D Specialist (Polio) of partnerships between BOUREIMA KONATÉ Page 4 C4D Specialist (Polio) stakeholders, and to design an JUSTIN MASRADAYE action plan to improve health C4D Consultant (Polio) and vaccination performance in BAKOLY RABENARIVO Frontline Focus the region. Regional C4D Specialist (Polio) Reaching previously hard NADIM BOUGHANMI Communication Officer -to-reach communities has Page 22 FACT CHECKING been emphasized this year. THOMAS MORBAN Working closely with different M&E Specialist (Polio) government entities as well as UNDER THE SUPERVISION OF LALAINA FATRATRA ANDRIAMASINORO local and traditional leaders, Keeping cVDPV in-check Chief of Communication such communities can now Globally and in Chad,the cVDPV GIANLUCA FLAMIGNI also benefit from life-saving situation is becoming a source Chief, Polio vaccinations. of concern.
    [Show full text]
  • English in India: Testing the Relative Productivity of Instruction Methods with Pratham English Language, Education Program.” Report Columbia University, New York
    From Mines and Wells to Well-Built Minds Well-Built to Wells Mines and From de la Brière, Filmer, Ringold, Rohner, Samuda, and Denisova Ringold, Rohner, Filmer, de la Brière, DIRECTIONS IN DEVELOPMENT Human Development From Mines and Wells to Well-Built Minds Turning Sub-Saharan Africa’s Natural Resource Wealth into Human Capital Bénédicte de la Brière, Deon Filmer, Dena Ringold, Dominic Rohner, Karelle Samuda, and Anastasiya Denisova From Mines and Wells to Well-Built Minds DIRECTIONS IN DEVELOPMENT Human Development From Mines and Wells to Well-Built Minds Turning Sub-Saharan Africa’s Natural Resource Wealth into Human Capital Bénédicte de la Brière, Deon Filmer, Dena Ringold, Dominic Rohner, Karelle Samuda, and Anastasiya Denisova © 2017 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved 1 2 3 4 20 19 18 17 This work is a product of the staff of The World Bank with external contributions. The findings, interpreta- tions, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Nothing herein shall constitute or be considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifically reserved.
    [Show full text]
  • "We Were Promised Development and All We Got Is Misery"
    brief 41 “We were promised development and all we got is misery”— The Influence of Petroleum on Conflict Dynamics in Chad Contents List of Acronyms and Abbreviations 4 5 New oil fields in Chad 55 Executive Summary 7 5.1 Carte blanche for non compliance with Acknowledgments 7 environmental standards 56 Introduction 8 5.2 Opaque information policy 57 5.3 The social dimension 58 1 Conflict Background 10 1.1 A history of conflicts in Chad 11 Conclusion 64 1.2 The current conflict set-up 11 Annex: List of interviews 69 1.3 Peace attempts 17 References 71 2 Managing Oil Wealth 20 2.1 Effects of resource wealth in fragile states 21 2.2 The petro-state 22 2.3 The need for good governance 23 3 The Chad-Cameroon Oil Pipeline Project 24 3.1 Oil exploration and exploitation in southern Chad 25 3.2 The initial flow of oil money 26 3.3 Capacity-building 27 3.4 Oversight institutions 28 3.5 Inherent shortcomings 28 3.6 First changes in the model project 30 4 The Impact of Oil on Conflict Fatal Transactions is funded by the Dynamics 32 European Union. The content of this project is the sole responsibility of Fatal 4.1 The dimension of production site conflict Transactions and can in no way be taken to reflect dynamics 33 the views of the European Union. 4.2 Power stabilization through oil revenues 47 4.3 Oil for arms 53 Title citation: Villager from Béro brief 41 “We were promised development and all we got is misery”— The Influence of Petroleum on Conflict Dynamics in Chad Claudia Frank Lena Guesnet 3 List of Acronyms and Abbreviations AG Tschad Arbeitsgruppe
    [Show full text]
  • THE MATERNAL HEALTH THEMATIC FUND Towards the 2030 Agenda: Leaving No One Behind in the Drive for Maternal Health
    THE MATERNAL HEALTH THEMATIC FUND Towards the 2030 Agenda: Leaving no one behind in the drive for maternal health Annual Report 2015 DELIVERING A WORLD WHERE EVERY PREGNANCY IS WANTED, EVERY CHILDBIRTH IS SAFE, AND EVERY YOUNG PERSON’S POTENTIAL IS FULFILLED. Cover photo: © Evelyn Matsamura Kiapi, UNFPA. Winner MHTF Annual Report 2015 photo competition OVERJOYED: Twenty-year-old Betty Nachu was one of the expectant mothers found waiting to deliver her baby at Rengen Health Centre II in Uganda’s Kotido district. She had travelled from Nakwakwa, a 10-kilometre journey, to wait for her labour to start. She was expecting her second child any time and chose to deliver at the health centre on the advice of a midwife. Only 19 per cent of women in Karamoja, a north-eastern region of Uganda, deliver at a health centre. Traditionally, the majority of pregnant women deliver at home; Nachu was not an exception at her first delivery. When two UNFPA-supported bonded midwives visited her village during a community outreach session, they convinced Nachu that giving birth at a health centre was safer. The bonded midwives sensitize expectant mothers about the benefits of delivering at the health centre under skilled care. TABLE OF CONTENTS ii | Acknowledgements iii | Acronyms iv | Foreword vii | Introduction Chapter One: 1 | Overview Chapter Two: 13 | The Midwifery Programme Chapter Three: 25 | Emergency Obstetric and Newborn Care Chapter Four: 35 | Maternal Death Surveillance and Response Chapter Five: 41 | The Campaign to End Fistula Chapter Six: 49 | First-Time Young Mothers Chapter Seven: 55 | Resources and Management Chapter Eight: 65 | Opportunities and the Way Forward Annexes: 73 | Annex 1.
    [Show full text]
  • Improvinc Women's Health: Issues & Interventions
    Public Disclosure Authorized IMPROVINCWOMEN'S HEALTH: ISSUES& INTERVENTIONS Epp Public Disclosure Authorized by Anne Tinker, Kathleen Finn and Joanne June 2000 Public Disclosure Authorized Public Disclosure Authorized H E W O R L D B A N K Improving Women's Health: Issues & Interventions By Anne Tinker, Kathleen Finn and Joanne Epp June 2000 CONTENTS Foreword ......................................................... 3 Acknowledgments ......................................................... 4 Summary of Key Issues and Interventions ......................................................... 5 Introduction ......................................................... 7 Determinants of Women's Health ...................... ................................... 9 Meeting Women's Health Needs in the Developing World .................................. 12 Safe Motherhood ........................................................ 13 Sexually Transmitted Infections including HIV/AIDS ......................................... 17 Malnutrition ........................................................ 19 Violence Against Women ........................................................ 21 Female Genital Mutilation ........................................................ 23 Conclusions ........................................................ 25 References............................................................................................................. 28 Appendix: Key Indicators of Women's Health Figures and Tables Figure 1: Determinants of women's health
    [Show full text]
  • Chad-Cameroon Petroleum and Pipeline Project (Loan No
    The Inspection Panel Investigation Report Chad-Cameroon Petroleum and Pipeline Project (Loan No. 4558-CD); Petroleum Sector Management Capacity Building Project (Credit No. 3373-CD); and Management of the Petroleum Economy (Credit No. 3316-CD) i About the Panel The Inspection Panel was created in September 1993 by the Board of Executive Directors of the World Bank1 to serve as an independent mechanism, which would ensure accountability in Bank operations with respect to its policies and procedures. The Inspection Panel is intended to be an instrument whereby groups of two or more citizens who believe that they or their interests have been or could be harmed by Bank-financed activities can present their concerns through a Request for Inspection. The Panel thus provides a link between the Bank’s highest governing body (the Board) and the people who are likely to be affected by the projects it finances. Members of the Panel are selected “on the basis of their ability to deal thoroughly and fairly with requests brought to them, their integrity and their independence from the Bank’s Management, and their exposure to developmental issues and to living conditions in developing countries.”2 The three-member Panel is empowered, subject to Board approval, to investigate problems that are alleged to have arisen as a result of the Bank having ignored its own operating policies and procedures. The Panel focuses on the Bank, not the Borrower. Its findings, which are presented in its Investigation Report, are sent to the World Bank Board of Directors. To date, the Panel has dealt with over 26 Requests for Inspection, including eight from Africa, seven from South Asia, nine from Latin American, and two from East Asia and the Pacific regions.
    [Show full text]