The first paper by Weiss et al. Drawing on quantitative data from the evaluation which had a quasi-experimental design, the authors show that the MOH-led Care Group model performed at least as well as the NGO-led model in achieving specific child health and nutrition outcomes. This finding suggests increased potential for sustainability. The second paper by Vesel at al.
The paper shows that the intervention had a positive effect on coping skills, stress levels and provider-provider and provider-client relationships, and observed associations between changes over time in coping skills and changes in relationships.
The authors argue that integrating psychosocial counseling and training interventions into health worker pre-service and in-service curricula would allow the positive effects of this intervention to be expanded across other areas of Sierra Leone. The third paper uses data from a somewhat similar project, entitled Quality Circles, which focused on interventions for both formal health workers and traditional birth attendants.
Authored by Higgins-Steele et al. They also indicate that improvements over time in organizational skills variables — problem-solving, strategizing and negotiation skills — were strongly associated with a change in some of the relationship variables.
The authors conclude that this approach of bringing together peers in a structured process of group work and individual skill development is critical in low-resources contexts, where active participation and resourcefulness of health workers can contribute to better health service delivery. The fourth paper by Fotso et al. Examining the influence of a male engagement project on the utilization and community-based delivery of MNCH care in a rural district of India, the authors found gender-based divisions of work and space in core areas of delivery and use of MNCH services.
The study ultimately unveils the complementarity of male and female CHWs in the community-based delivery of, and increased demand for, MNCH services. Finally, the concluding commentary by Lehmann casts the four papers in the broader context of human resources strengthening for health systems resilience.
The author suggests that the interventions reviewed by this set of papers be viewed along a continuum of program strengthening and systems resilience: repairing damage caused in the past, strengthening systems going forward, and introducing new actors by extending traditionally female-dominated community-level care to include men.
The commentary ends with critical questions related to scale up and sustainability. It seeks to develop and test innovative interventions and strategies to address common barriers that prevent essential health services from reaching women and children. C Halve, by , the proportion of people without sustainable access to safe drinking water and basic sanitation 7. D By , to have achieved a significant improvement in the lives of at least million slum dwellers 7.
A Develop further an open, rule-based, predictable, non-discriminatory trading and financial system. Includes a commitment to good governance, development and poverty reduction - both nationally and internationally Some of the indicators listed below are monitored separately for the least developed countries LDCs , Africa, landlocked developing countries and small island developing States.
Official development assistance 8. B Address the special needs of the least developed countries Includes: tariff and quota free access for the least developed countries' exports; enhanced programme of debt relief for heavily indebted poor countries HIPC and cancellation of official bilateral debt; and more generous ODA for countries committed to poverty reduction Target 8.
C Address the special needs of landlocked developing countries and small island developing States through the Programme of Action for the Sustainable Development of Small Island Developing States and the outcome of the twenty-second special session of the General Assembly Target 8. D Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term Target 8.
These will be discussed under interviews carried out with national disaster management heads. It is further stated that the chances of halting this scourge by are becoming slimmer WHO Malawi is listed amongst the top 20 African countries that are making great progress in achieving this goal and consistently reducing HIV prevalence.
The documents obtained were labelled differently, as: policies, decrees, acts, frameworks, reports, plans and bills. Table 4 illustrates the list of countries and the collected statutes for each country. This was presented in Table 5. Any mentioning of any of these words in the statutes is assumed to be a possible state of readiness for dealing with MDG 6 through the existence of clinics, Paramedic and Health Ministries.
MDGs are an international initiative which require national legal documents to support the initiative and share the same goals. The disaster management statute of each SADC country is discussed in relation to the MDG 6, its recognition of health issues, support of the involvement of different disciplines and sectors in preventing and mitigating the impact of diseases are also taken into consideration.
These documents could not be found on the internet for analysis. The policy recognises the Ministry of Health as the focal point for dealing with epidemics. Identification and recognition of these national and international organisations is a positive indication for fighting and mitigating the impacts of diseases as well as possible support for MDGs Botswana Unfortunately this document is in French and could not be interpreted.
According to Dr J. Lukusa, a Congolese disaster management student, there is no whole Act for Disaster Management but each relevant ministry has a section of disaster management. The Mozambique document is in Portuguese, however, valuable information was gathered during a telephone interview. Plagues, epidemics and diseases are mentioned in the definition of disaster, as possible occurrences that might threaten life or the wellbeing of a community.
This could be an indication that Mauritius is still reactive rather than proactive about this epidemic, or their Act was not posted online.
There is the possibility that this Ministry also advises and updates the President about the advancement in MDG 6. The Namibian Vulnerability Assessment Committee, constituencies and sub-committees have representatives for health emergency management and nurses who are usually the primary health care providers and best advocates for fighting diseases. Furthermore, according to Griffiths and Maben nurses are crucial to the delivery of 21st century healthcare.
Another positive aspect of the Disaster Risk Management Act 10 of is the support and participation of organisations such as the WHO for health issues in Namibia. Seychelles According to Ms Divina Sabino, the head of Risk and Disaster Management which is a division within the Ministry of Environment and Energy, the disaster management policy is currently being updated and has been submitted to the cabinet for endorsement.
Tanzania In the Disaster Relief Coordination Act 9 of , under the definition of disaster, medical care is mentioned as a need that should be provided.
This is a possible indication that MDG 6 is provided for by the disaster management fraternity. Specifically in the Disaster Management Framework of , under Key Performance Area 1, on integrated institutional capacity for disaster risk management, it is stated that an effective and comprehensive disaster risk management strategy cannot be achieved without participative decision making, involving a wide range of role players.
It also states that it is imperative, for disaster risk management in South Africa, to be informed by a global perspective so that it remains at the cutting edge of developments. It must associate itself with selected international development protocols, agendas and commitments, such as the millennium development goals outlined in the UN Millennium Declaration. Having such guidance in the National Framework is a strong indication of the South African Governments participation in achieving the goals of the MDGs.
To keep abreast of international developments, the framework has key performance indicators, and one relevant indicator specific to this study is that a disaster risk management forum must be established for the purpose of co-operation with countries in the SADC region, for effective operation. Zambia In the respective Act 13 of , health care is mentioned as an essential commodity, which is a positive recognition when it comes to dealing with any diseases that might threaten Zambia.
Epidemics are listed as potential hazards that might affect the country, and this is a form of preparedness. For the successful achievement of MDG 6, all relevant experts needed to avert epidemics are required to be involved on the Zambian National Disaster Management Council Zambia The Ministry of Health forms part of this council.
Records showing the location of health facilities and the particulars of health practitioners are mandated to be included. This is a positive perspective. There is also a National Civil Protection Committee mentioned in this definition, of which the Secretary for Health should be a member.
Whilst a declaration of a state of disaster is in force, the civil protection officer may, by order in writing, direct any person to maintain specified stocks of medical supplies and other supplies for use during the disaster. This is a positive section in the Civil Protection Act 5 of which indicates support for the forestalling of any disease and the possible contribution to the achievement of MDG 6, given the availability and accessibility of resources in the country.
However, this Act does not show any support or mention of any international arrangements. However, there was no answer from Madagascar, Tanzania or Angola. The number listed for Mauritius was for the Weather Services Department and, hence, there was no success.
For the DRC, Botswana, Namibia, Zambia, Lesotho and Swaziland, the respondents requested the questionnaire to be emailed to them, but it was never returned. Numerous follow-up phone calls were made to no avail. From the telephone interviews conducted with heads of departments or representatives designated by their heads, the responses were categorised into the following five findings: knowledge of MDG 6 strategies and projects implemented or involved in successes and challenges encountered with halting MDG6 other diseases being dealt with countries rating of the achievement of MDG 6 before Mozambique: Ms S.Though task-shifting may not be the entire answer to the health workforce crisis, it certainly is part of the solution [ 25 ]. Another positive aspect of the Disaster Risk Management Act 10 of is the support and participation of organisations such as the WHO for health issues in Namibia. The indicators were also used in the telephone interview questionnaire asked to heads of SADC national disaster management centres. B Achieve, by , universal access to reproductive health 5. The key drivers fuelling the spread of the disease in the region are the widespread practice of polygamous relationships as well as the multiple sex partners that many men have at any given time.
Zimbabwe: Ms Sibusiso Ndlovu, the representative for Civil Protection Department Zimbabwe, explained the following in an email response: It would not be meaningful for us to complete this questionnaire; Coordination of achieving MDGs is under an inter-ministerial committee set up specifically for that task.
They also carry out vulnerability assessments on a yearly basis.
There is also a National Civil Protection Committee mentioned in this definition, of which the Secretary for Health should be a member. Such approaches are critical first steps towards developing the proper policies and plans required to improve the effectiveness of the public health workforce in a sustainable way [ 15 , 16 ]. Finally, the concluding commentary by Lehmann casts the four papers in the broader context of human resources strengthening for health systems resilience. Most of the documents analysed were downloaded from the websites of the various countries. Zambia In the respective Act 13 of , health care is mentioned as an essential commodity, which is a positive recognition when it comes to dealing with any diseases that might threaten Zambia.
The goals and targets are interrelated and should be seen as a whole.
The process engaged communities in low-resource settings, tapped unheard or unconventional voices at both global and country levels, and honed the ideas through cross-disciplinary inputs from experts from many different fields. One of the main challenges in delivering essential and life-saving interventions to avert these deaths is the shortage of a well-trained, supervised, and motivated health workforce [ 8 , 9 ]. These documents could not be found on the internet for analysis. A first set of projects referred to as Phase I were designed, implemented and evaluated between and See Additional file 1. The analysis of some of the obtained statutes did indicate that they embraced the support to fight and contain diseases. The result, in , was the inclusion of the new MDG target relating to employment listed above and the following four employment indicators intended to monitor progress toward the new target : 1.
This included anti-retroviral treatment.
A Develop further an open, rule-based, predictable, non-discriminatory trading and financial system. This is worrisome because of the infection rate in low and middle income countries where approximately women and men aged 15—24 were newly infected with HIV in A Reduce by three quarters, between and , the maternal mortality ratio 5. Task-shifting has improved access and quality of care in a variety of settings [ 21 — 23 ]. This is a positive section in the Civil Protection Act 5 of which indicates support for the forestalling of any disease and the possible contribution to the achievement of MDG 6, given the availability and accessibility of resources in the country.
Zimbabwe: Ms Sibusiso Ndlovu, the representative for Civil Protection Department Zimbabwe, explained the following in an email response: It would not be meaningful for us to complete this questionnaire; Coordination of achieving MDGs is under an inter-ministerial committee set up specifically for that task. It was recommended that disaster managers should be part of the Post MDG delegation. The initial response, from the South African National Disaster Management Centre, before the questionnaire was filled in by its Head, was that the disaster management centres are not involved in or deal with any issues related specifically to the health issues of the millennium development goals. A Ensure that, by , children everywhere, boys and girls alike, will be able to complete a full course of primary schooling 2. For the DRC, Botswana, Namibia, Zambia, Lesotho and Swaziland, the respondents requested the questionnaire to be emailed to them, but it was never returned.
For the research design and methodology of the study, various data gathering tools were employed. They also carry out vulnerability assessments on a yearly basis. For example, Botswana has a total population of 1. A Halve, between and , the proportion of people whose income is less than one dollar a day 1.