Thousands of Zimbabwean women have been subjected to several forms of torture,
including rape, throughout the country's current political, economic and humanitarian crisis,
according to a new report produced by the Zimbabwe Torture Victims/Survivors Project.
The report was written to coincide with South Africa's 'Sixteen days on gender activism'. It
shows that a significant proportion of the women who have fled Zimbabwe for South
Africa have experienced state torture. Large numbers of Zimbabwean women are fleeing
their homes and even their country to avoid violence.
Zimbabwe's ongoing crisis has resulted in a dramatic increase in state violence. More than
15,000 cases of organized torture and violence have been documented in Zimbabwe since
2001, according to the Human Rights Forum.
Among the Zimbabweans who have fled their homes for South Africa, 40% are woman,
according to a small sample surveyed in the Gauteng Province. Thirty percent complain
they suffered political violence and 44% report having been denied access to food because
of their support for the opposition, according to a snap survey carried out by ZTVP in 2005.
The Zimbabwe Torture Victims/Survivors Project (ZTVP) offers medical assistance,
counselling and limited social assistance to Zimbabwean survivors of torture who are living
in South Africa. The project has been operating in Johannesburg, based at the Centre for the
Study of Violence and Reconciliation, since February 2005.
Women make up 32% of all torture survivors seen by the project from February 2005 to
September 2006. More than 84% of the women have arrived in South Africa since 2004.
They are young, with an average age of 29, and mostly single. More than half (63%) had
some form of employment in Zimbabwe. Most (67%) report that they were politically
active in some way, with 43% reporting membership in the opposition party, the Movement
for Democratic Change (MDC). Most (70%) came from Zimbabwe's urban areas and most
came from Matabeleland in southwestern Zimbabwe.
Significantly, 15% reported that they had been subjected to rape, which is much higher than
recorded by earlier human rights reports. Beatings, sensory over-stimulation, burnings,
falanga (beatings of the soles of the feet), electric shock were other forms of torture
reported by the women. Nearly half the women reported multiple violations. They reported
that the violence was inflicted by supporters of Zanu-PF (48%), war veterans (17%), police
(10%), army (5%) and the Central Intelligence Organisation (5%).
The report features several harrowing first-person accounts of rape experienced by the
women. The ZTVP also has a video about the problem of rape in Zimbabwe.
The survey found that women who reported rape were also significantly more likely to
report severe torture, particularly beatings. The women who reported rape were
significantly more likely to be assessed as suffering psychological problems following the
trauma.
The report highlights that only 36% of the Zimbabwean women torture survivors have
received a Section 22 status, which is the first step of applying for refugee status. Only 2%
had succeeded in getting refugee status.
\"Given the strong prima facie grounds that these women have for acquiring asylum, it is a
disgrace that so few have been accorded such status,\" concludes the report. \"Not only does
it seem that the South African authorities have scant regard for the application of its own
Refugee Act, but also that they seem oblivious to the enormous literature pointing out the
need for special treatment of women refugees.\"
Water, health and poverty are closely linked to each other. Health and poverty have twoway
relationship: good health brings prosperity, and prosperity brings improvements in
health; or conversely poor health may create and perpetuate poverty and poverty may
lead to poor health. Water is at the center and contributes to both health and poverty.
Water influences health through direct consumption for drinking and for sanitation, and for
its use in food and nutrition in the households. Water also contributes to livelihoods of the
poor as a key input in the production process in agricultural and non-agricultural uses and
in the environment in which poor people live and depend on. Good human health and
environmental health contributes to poverty reduction, and vice versa, with water being
key to both. Poverty causes natural resources degradation, influencing environmental
health, which in turn creates more poverty. These linkages are examined in this paper
using a simplified framework using available general data for Sri Lanka and cases
extracted from other research outputs in the country. Key lessons are highlighted in
relation to social safety nets, the importance of covering ground water resources in the
development of the Water Policy, and the need for improved irrigation management,
particularly noting the interaction between irrigation water and domestic water in the rural
areas.
LR: 20091118; JID: 101245734; OID: NLM: PMC1440852; 2005/10/05 [received]; 2006/03/28 [accepted]; 2006/03/28 [aheadofprint]; epublish
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", "tags": [], "relations": {}, "dateAdded": "2011-04-08T09:37:33Z", "dateModified": "2011-04-08T09:37:33Z" } }, { "key": "SJNH8APN", "version": 1, "library": { "type": "group", "id": 42696, "name": "OER Case Studies in Public Health", "links": { "alternate": { "href": "https://www.zotero.org/groups/oer_case_studies_in_public_health", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/42696/items/SJNH8APN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/oer_case_studies_in_public_health/items/SJNH8APN", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/42696/items/G9SDTTHB", "type": "application/json" } }, "meta": { "createdByUser": { "id": 324108, "username": "alexan054", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/alexan054", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "SJNH8APN", "version": 1, "parentItem": "G9SDTTHB", "itemType": "note", "note": "BACKGROUND: Published practical examples of how to bridge gaps between research, policy and practice in health systems research in Sub Saharan Africa are scarce. The aim of our study was to use a case study approach to analyse how and why different operational health research projects in Africa have contributed to health systems strengthening and promoted equity in health service provision. METHODS: Using case studies we have collated and analysed practical examples of operational research projects on health in Sub-Saharan Africa which demonstrate how the links between research, policy and action can be strengthened to build effective and pro-poor health systems. To ensure rigour, we selected the case studies using pre-defined criteria, mapped their characteristics systematically using a case study development framework, and analysed the research impact process of each case study using the RAPID framework for research-policy links. This process enabled analysis of common themes, successes and weaknesses. RESULTS: 3 operational research projects met our case study criteria: HIV counselling and testing services in Kenya; provision of TB services in grocery stores in Malawi; and community diagnostics for anaemia, TB and malaria in Nigeria. Political context and external influences: in each case study context there was a need for new knowledge and approaches to meet policy requirements for equitable service delivery. Collaboration between researchers and key policy players began at the inception of operational research cycles. Links: critical in these operational research projects was the development of partnerships for capacity building to support new services or new players in service delivery. Evidence: evidence was used to promote policy dialogue around equity in different ways throughout the research cycle, such as in determining the topic area and in development of indicators. CONCLUSION: Building equitable health systems means considering equity at different stages of the research cycle. Partnerships for capacity building promotes demand, delivery and uptake of research. Links with those who use and benefit from research, such as communities, service providers and policy makers, contribute to the timeliness and relevance of the research agenda and a receptive research-policy-practice interface. Our study highlights the need to advocate for a global research culture that values and funds these multiple levels of engagement.
", "tags": [], "relations": {}, "dateAdded": "2011-04-08T09:37:33Z", "dateModified": "2011-04-08T09:37:33Z" } }, { "key": "ZVJCXTDW", "version": 1, "library": { "type": "group", "id": 42696, "name": "OER Case Studies in Public Health", "links": { "alternate": { "href": "https://www.zotero.org/groups/oer_case_studies_in_public_health", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/42696/items/ZVJCXTDW", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/oer_case_studies_in_public_health/items/ZVJCXTDW", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/42696/items/M5M2SUFJ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 324108, "username": "alexan054", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/alexan054", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "ZVJCXTDW", "version": 1, "parentItem": "M5M2SUFJ", "itemType": "note", "note": "BACKGROUND: Globally, immunization services have been the center of renewed interest with increased funding to improve services, acceleration of the introduction of new vaccines, and the development of a health systems approach to improve vaccine delivery. Much of the credit for the increased attention is due to the work of the GAVI Alliance and to new funding streams. If routine immunization programs are to take full advantage of the newly available resources, managers need to understand the range of proven strategies and approaches to deliver vaccines to reduce the incidence of diseases. In this paper, we present strategies that may be used at the sub-national level to improve routine immunization programs. METHODS: We conducted a systematic review of studies and projects reported in the published and gray literature. Each paper that met our inclusion criteria was rated based on methodological rigor and data were systematically abstracted. Routine-immunization - specific papers with a methodological rigor rating of greater than 60% and with conclusive results were reported. RESULTS: Greater than 11,000 papers were identified, of which 60 met our inclusion criteria and 25 papers were reported. Papers were grouped into four strategy approaches: bringing immunizations closer to communities (n = 11), using information dissemination to increase demand for vaccination (n = 3), changing practices in fixed sites (n = 4), and using innovative management practices (n = 7). CONCLUSION: Immunization programs are at a historical crossroads in terms of developing new funding streams, introducing new vaccines, and responding to the global interest in the health systems approach to improving immunization delivery. However, to complement this, actual service delivery needs to be strengthened and program managers must be aware of proven strategies. Much was learned from the 25 papers, such as the use of non-health workers to provide numerous services at the community level. However it was startling to see how few papers were identified and in particular how few were of strong scientific quality. Further well-designed and well-conducted scientific research is warranted. Proposed areas of additional research include integration of additional services with immunization delivery, collaboration of immunization programs with new partners, best approaches to new vaccine introduction, and how to improve service delivery.
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Increasing the use of existing VCT, through improved access to quality services, was the main objective of the USAID HIV/AIDS Prevention Program for Central America and Mexico implemented by Population Services International (PSI), the Pan-American Social Marketing Organization (PASMO) and the Institute for Reproductive Health (IRH) at Georgetown University.
The Patient Voices digital stories use video, audio, still images and music to convey patients', carers', practitioners' and managers' own stories in a unique way. They are intended to touch the hearts of managers, clinicians and others striving to improve the quality of health and social care, and our workshops being are increasingly used to engage with, and evidence outputs from, the Patient and Public Involvement (PPI) and patient engagement agendas, together with being used to provide qualitative evidence of the patient experience.
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Despite rapid and tangible progress in vaccine coverage and in premature mortality rates registered in sub-Saharan Africa, inequities to access remain firmly entrenched, large pockets of low vaccination coverage persist, and coverage often varies considerably across regions, districts, and health facilities' areas of responsibility. This paper focuses on system-related factors that can explain disparities in immunization coverage among districts in Burkina Faso.
Methods
A multiple-case study was conducted of six districts representative of different immunization trends and overall performance. A participative process that involved local experts and key actors led to a focus on key factors that could possibly determine the efficiency and efficacy of district vaccination services: occurrence of disease outbreaks and immunization days, overall district management performance, resources available for vaccination services, and institutional elements. The methodology, geared toward reconstructing the evolution of vaccine services performance from 2000 to 2006, is based on data from documents and from individual and group interviews in each of the six health districts. The process of interpreting results brought together the field personnel and the research team.
Results
The districts that perform best are those that assemble a set of favourable conditions. However, the leadership of the district medical officer (DMO) appears to be the main conduit and the rallying point for these conditions. Typically, strong leadership that is recognized by the field teams ensures smooth operation of the vaccination services, promotes the emergence of new initiatives and offers some protection against risks related to outbreaks of epidemics or supplementary activities that can hinder routine functioning. The same is true for the ability of nurse managers and their teams to cope with new situations (epidemics, shortages of certain stocks).
Conclusion
The discourse on factors that determine the performance or breakdown of local health care systems in lower and middle income countries remains largely concentrated on technocratic and financial considerations, targeting institutional reforms, availability of resources, or accessibility of health services. The leadership role of those responsible for the district, and more broadly, of those we label \"the human factor\", in the performance of local health care systems is mentioned only marginally. This study shows that strong and committed leadership promotes an effective mobilization of teams and creates the conditions for good performance in districts, even when they have only limited access to supports provided by external partners.
Malaria is the most common cause of death in Mozambican children. We worked with the Ministry of Health to provide technical support to strengthen the National Malaria Strategic Plan
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