Access to health care is a complex issue of constitutional significance. There are significant numbers of people in South Africa who do not have adequate access to health services due to geographical, financial, physical, communication, sociological (such as unfair discrimination and stigmatisation)and other barriers. Access to medical schemes is diminishing in real terms. Medical schemes provide financing for almost 7 million people but over the years membership figures have declined as a percentage of the general population. This is due in part to major increases in non-health expenditure by medical schemes on items such as administration and brokers fees. This Charter commits to move towards a coherent, unified health system offering financial protection for all the population in accessing a nationally affordable package of health care at the time of need and to improve access to health care services.
Public-Private Mix
The 2007 edition of the South African Health Review focuses on broad areas with respect to the role of the private health sector i.e. oversight, pooling of resources and purchasing of health care, delivery of health care services and health and related indicators.
Previous studies in the public sector in Tanzania, have demonstrated major prescribing problems due to poly-pharmacy and irrational use of antibiotics and injections. Little is understood about prescribing in the private sector. This paper measures and compares prescribing practices in public and private dispensaries in Kibaha District Tanzania. Prescribing of antibiotic and injections was significantly higher in private than in public dispensaries (P<0.05). The extent of prescribing in private dispensaries calls for intervention to reduce overuse of antibiotics and injections.
A cross sectional study was conducted in rural areas of Kibaha district within the Coastal region of Tanzania to assess knowledge on dosage, storage, expiry and dispensing practices of antimalarial drugs among households, drug stores and ordinary shops. The majority of drug store (53 %) and ordinary retail shop (75 %) sellers did not dispense correct doses of antimalarials due to low literacy and lack of dosage guidelines or package inserts. In order to reduce incidences of drug poisoning due to over-dosage or drug resistance due to under dosage, there is need to educate both consumers and dispensers on correct dosage regimens through mass media such as radio, health education programs, television, posters, leaflets and newspapers.
This study analyses the economic potential of pharmaceutical production of Anti Retroviral Drugs (ARVs) in Tanzania. This includes an analysis of the pharmaceutical sector in the country and the potential to export ARVs to the region. The study shows that production of pharmaceutical products in Tanzania is on the rise and can become viable in the long term. Even though the overall drug market is rather small, public health related drugs have a significant, largely donor based, market.
The UN health chief urged countries to come up with new ways to make medicine for HIV/AIDS and other diseases more affordable in the world's poorest countries, without stifling innovation among pharmaceutical companies. WHO's 193 member states are looking to forge a global strategy on the highly divisive issues of drug development, patenting and pricing.
Global public-private health partnerships, as a means of global health
governance, have become increasingly common. Initially, much was
expected of them but enthusiasm has now waned, with concern raised over
costs and unanticipated consequences. What bad habits impact negatively
on their performance and what actions could make them more effective?
This paper explodes Rand Water’s rhetoric about itself as a promoter of “public” services.The paper discusses the context of changes in public sector management and in the water sector. Rand Water (RW), the biggest public water utility in Africa entering the market on the continent engage in other activities that are beyond its core function of providing bulk potable water to local government in the industrial heartland of South Africa. This report examines the expansion of RW into non-core activities in the period 1994-2006, the rationales offered by RW for that expansion, and deliberates on this expansion in the context of similar activities by other public sector operations both in South Africa and in other countries.
At the inception of Uganda's second 5-year Health Sector Strategic Plan (HSSP II), this paper traces the history of the public - private partnership for health (PPPH) in Uganda, giving its justification and mandate. It also gives its current state of the art, outlining the successes scored, the challenges still faced in its implementation and current efforts being made to make it comprehensively institutionalized. The successes include the bilateral acceptance of the principle and need for partnership by both the public and private partners, the overt gestures by the public partner through direct funding of the private providers, the ceding of some responsibilities to private players and the acceptance by the private players to take on some public responsibilities using their own resources. The challenges include the slow formalization of the partnership, skepticism about autonomy, the stagnation of government funding, the poor understanding of the partnership at sub-national levels and poor sharing of information, among others. These challenges are now further compounded by the recent introduction of new policy reforms like fiscal decentralisation to the same local officials who do not fully appreciate the partnership and are therefore not likely to support it. The paper concludes with some useful suggestions on how these challenges may be tackled.
The Health Sector Strategic Plan (HSSP) aims to ensure access to basic health care by the Ugandan population through the delivery of the National Minimum Health Care Package (NMHCP). This requires availability of well-trained health professionals. This study demonstrates that the Private-Not-For-Profit (PNFP) Health Training Institutions - the majority in Uganda - have remained grossly under-funded, which poses a threat to achievement of the HSSP. They are faced with decreasing income from fees, dwindling donor support and over-dependence on government grants which are both uncertain and erratic. Consequently, vital activities for students' training such as field trips, teaching and reading materials are left unsatisfied as a copying mechanism, but not without negative implications for quality. It is recommended that government increases and guarantees its support to these Health Training Institutions as a way of maintaining quality of health worker training. At the same time, the training institutions need to diversify their funding options to include designing short tailor-made courses, mobilizing alumni contributions, research and consultancies, self-help projects like farming, canteens and stationeries as well as fund-raising activities as a way of bridging their funding gap. This should be coupled with more efficiency mechanisms and prudent management to avoid wastage of the already scarce financial resources.