Monday, 22 August 2011
Sunday, 14 August 2011
Wednesday, 10 August 2011
Nearly one third of Tanzanian girls experience sexual violence before they turn 18, a Unicef survey has found.
The figure among boys is 13.4%, says the UN children's agency.
The most common form of abuse is sexual touching, followed by attempted intercourse, it says.
Unicef official Andy Brooks said the survey was the most comprehensive carried out on this issue in any country and showed the government was prepared to tackle the problem.
"Tanzania is the first country with the courage to expose the full extent of child abuse among boys and girls," he told the BBC's Focus on Africa programme.
The survey also found that of those who had sex before they turned 18, 29.1% of females and 17.5% of males reported that their first encounter was unwilling.
This meant they were forced or coerced to engage in sexual intercourse, Unicef said.
Tanzania's Education Minister Shukuru Kawambwa said the government was determined to end sexual abuse.
It would set up reporting mechanisms for abuse victims and would urge teachers to take care of vulnerable children, he said.
Mr Brooks said similar surveys would be carried out in Kenya, Rwanda, Malawi, Zimbabwe and South Africa.
Tanzanian girls risking rape for an education
Friday, 5 August 2011
31 July 2011
The recent direction of the Supreme Court of India to government hospitals in Delhi to refer poor patients to private hospitals gains significance not only as one more pro-poor judicial pronouncement but also because it highlights one of the major contradictions in India's health care service: even as there has been a mushrooming of huge, well-equipped, multi-discipline hospitals in big cities serving the rich, thousands of rural India's poor patients have to go without even a semblance of medical care when they desperately need it.
A two-member bench of the apex court comprising Justice R.V. Raveendran and A.K. Patnayak said that private hospitals would provide the patients from the crowded government hospitals necessary treatment free of cost, pending the preparation of a scheme that would involve private hospitals in treating the poor. It is perhaps to find out how far the private hospitals are right in claiming that if they provide total free treatment to the poor they would become bankrupt. When one of the counsels of the private hospitals told the court that nobody was occupying the beds allotted for the poor, the Bench responded stating, “It means you are not welcoming anybody.”
The Bench was hearing an appeal filed by private hospitals against a 2007 judgment of the Delhi High Court, which directed the private hospitals to ensure free treatment to 10 per cent of in-patients and 25 per cent of outpatients. The High Court ruling made it mandatory for private hospitals on the ground that they had received subsidised land after giving an undertaking that the hospitals they built would provide free treatment to the economically weaker sections of the people.
The Supreme Court directed the Delhi government and the private hospitals to draw the necessary modalities for the purpose. During an earlier hearing of the appeal, the court came down heavily on the private hospitals. Stating that they behaved like “star hotels,” they were highly critical of these hospitals for collecting abnormal charges from the poor. They also took strong objection to their failure to honour their word and violation of the condition that the poor be given free treatment.
The Supreme Court's bold initiative should enthuse social activists, political parties, and the media to carry the message that there is an urgent need to strengthen the public health security system in the country so that deprived sections of the people could have greater access to medical assistance in time. Only recently Nobel laureate Amartya Sen warned that gigantic inequalities in access to healthcare would lead to poor health in general. Commending the splendid work done by human rights activist, Dr. Binayak Sen among tribal people, he said that inequality in access to healthcare was not only bad distribution of the overall health benefits; it also reduced the overall health benefit.
The Lancet 6 August 2011
Raj Bhopal a, Gary J Macfarlane b, William Cairns Smith c, Robert West d, on behalf of the Management Executive Committee for the XIX World Congress of Epidemiology
Epidemiology is thriving. The striking features of contemporary epidemiology are diversity, change, and global reach: from society to the molecule, responding to technical advances and changing patterns of disease. The two main challenges are: translating epidemiology into evidence, practice, and ultimately better health; and strengthening epidemiology research capacity, particularly in low-income and middle-income countries.
Epidemiology is confronting old and new threats to human health and wellbeing. Established threats, such as tobacco, alcohol, and tuberculosis, that are controlled in some places are affecting new populations, particularly in low-income and middle-income countries. Further evidence on alcohol consumption and related harms is informing the development of public health policy on alcohol. New threats, such as volcanic ash and Shiga toxin-producing Escherichia coli, are posing new challenges. Re-emerging threats of poliovirus and measles along with neglected tropical diseases1 that affect about a billion people all need to be tackled with epidemiological concepts and methods used in tobacco control. Furthermore, understanding of population change through urbanisation, migration, and ageing, and inequalities arising in modern societies, is critical to epidemiology as a population-based discipline.
Epidemiological methods are evolving through multidisciplinary collaboration with other areas of expertise, including basic sciences, computing, and social sciences. New and improved methods of assessment of exposures, analysis of gene—environment interactions, informatics, biobanking, spatial analysis and graphic presentation, and approaches to mixed qualitative—quantitative methods are emerging from cross-disciplinary working.
Epidemiology is a discipline with a broad international reach where robust evidence can be generated by the application of sound epidemiological methods in a range of different settings using modest resources. Increasing global connectivity has facilitated the development of epidemiology through open access to electronic publication databases, sharing of research tools, and knowledge exchange through interactive websites and discussion lists. Supercourse,2 a dynamic repository of lectures on epidemiology and global health, is an excellent example of this global connectivity.
The International Epidemiology Association's XIX World Congress of Epidemiology3 to be held in Edinburgh on Aug 7—11, hosted by the academic departments of public health in Scotland, has adopted five overarching strategic themes: global problems; chronic diseases; cutting edge methodology; epidemiology and policy; and neglected conditions. Epidemiology and policy is the one theme generating most interest among those attending.
The generation of increasing volumes of evidence by epidemiology is of little consequence unless that knowledge influences policy and practice, in addition to improving our understanding of aetiology and causal pathways. Given that epidemiology needs to be relevant for policy, it needs to be presented in a meaningful way for policy makers. This requires recognition of the different language used by epidemiologists and policy makers, as well as their very different timescales—epidemiologists operate over years if not decades, whereas policy makers make shorter term decisions. Policy makers need to learn more about epidemiological strengths and limitations while epidemiologists need to understand the timescales and cycles in policy making and political processes. Epidemiology also needs to be applied to individual patient care in the assessment of risk at an individual level, tailoring preventive and therapeutic interventions as is increasingly the case in cardiovascular disease.
The second challenge for the future is capacity strengthening. Masters level courses in epidemiology are widely available in all regions through medical schools and universities, often with North—South collaboration. These courses provide an understanding and an appreciation of epidemiological research methods, but it requires doctoral and post-doctoral level programmes to develop advanced and practical research skills in epidemiology. An important challenge for the International Epidemiology Association at both regional and international level is the facilitation of advanced epidemiology training to develop research capacity, particularly in low-income and middle-income countries. The forthcoming XIX World Congress of Epidemiology will be preceded by an advanced course in epidemiological methods. The 1500 Congress delegates will debate the challenges of relevance to policy and practice, and capacity building at a global level.
1 WHO. First WHO report on neglected tropical diseases 2010: working to overcome the global impact of neglected tropical diseases. Geneva: WHO, 2010.
2 WHO Collaborating Center University of Pittsburgh. Supercourse: epidemiology, the internet, and global health.http://www.pitt.edu/∼super1. (accessed July 18, 2011).