There is re-emerging interest in community health workers (CHWs) as part of wider policies regarding task-shifting within human resources for health. This paper examines the history of CHW programmes established in South Africa in the later apartheid years (1970s–1994) – a time of innovative initiatives. After 1994, the new democratic government embraced primary healthcare (PHC), however CHW initiatives were not included in their health plan and most of these programmes subsequently collapsed. Since then a wide array of disease-focused CHW projects have emerged, particularly within HIV care.Thirteen oral history interviews and eight witness seminars were conducted in South Africa in April 2008 with founders and CHWs from these earlier programmes. These data were triangulated with written primary sources and analysed using thematic content analysis. The study suggests that 1970s–1990s CHW programmes were seen as innovative, responsive, comprehensive and empowering for staff and communities, a focus which respondents felt was lost within current programmes. The growth of these earlier projects was underpinned by the struggle against apartheid. Respondents felt that the more technical focus of current CHW programmes under-utilise a valuable human resource which previously had a much wider social and health impact. These prior experiences and lessons learned could usefully inform policy-making frameworks for CHWs in South Africa today.

BackgroundIn India very few of those who need mental health care receive it, despite efforts of the 1982 National Mental Health Programme and its district-level component the District Mental Health Programme (DMHP) to improve mental health care coverage.AimsTo explore and unpack the political, cultural and other historical reasons for the DMHP’s failures and successes since 1947 (post-independence era), which may highlight issues for today’s current primary mental health care policy and programme.MethodsOral history interviews and documentary sourcing were conducted in 2010–11 with policy makers, programme managers and observers who had been active in the creation of the NMHP and DMHP.ResultsThe results suggest that the widely held perception that the DMHP has failed is not entirely justified, insofar that major hurdles to the implementation of the plan have impacted on mental health coverage in primary care, rather than faults with the plan itself. These hurdles have been political neglect, inadequate leadership at central, state and district levels, inaccessible funding and improperly implemented delivery of services (including poor training, motivation and retention of staff) at district and community levels.ConclusionAt this important juncture as the 12th Five Year Plan is in preparation, this historical paper suggests that though the model may be improved, the most important changes would be to encourage central and state governments to implement better technical support, access to funds and to rethink the programme leadership at national, state and district levels.

Binge drinking is a matter of current social, media and political concern, and the focus of much policy activity in the UK. Binge drinking is associated with causing a wide range of harm to individuals (e.g. accidents), and the wider community (e.g. crime and disorder). Within the current discourse, binge drinking is seen primarily as a youth issue. Binge drinking is sometimes portrayed as a recent phenomenon, but we know from history that heavy drinking has been endemic in British society over many centuries. Using a contemporary history perspective, this paper explores the concept of binge drinking. It considers the definitions in use, recent shifts in meaning and also the way in which different definitions of binge drinking impact on perceptions of the extent and nature of binge drinking. The paper concludes with some thoughts and questions about the usefulness of the concept of binge drinking as it currently used, and areas for further research.

Advertising has a dual function for British public health. Control or prohibition of mass advertising detrimental to health is a central objective for public health in Britain. Use of mass advertising has also been a more general public health strategy, such as during the initial government responses to HIV/AIDS in the 1980s. We trace the initial significance of mass advertising in public health in Britain in the postwar decades up to the 1970s, identifying smoking as the key issue that helped to define this new approach. This approach drew from road safety and drink driving models, US advertising theory, relocation of health education within the central government, the arrival of mass consumption, and the rise of the "new public health" agenda.