Activism: working to reduce maternal mortality through civil society and health professional alliances in sub-Saharan Africa

Ray, Sunanda; Madzimbamuto, Farai; Fonn, Sharon

doi:10.1016/s0968-8080(12)39617-1

Cited by 30 publications

(48 citation statements)

References 21 publications

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“…Given the imbalance between need and access, countries in the global South took centre stage in resistance movements to advocate for treatment access. Activists from groups such as the Treatment Action Campaign (TAC) in South Africa advocated for the provision of antiretroviral (ARV) medications for those who needed them, even in low-income societies [16,17,30]. Scholarship underscores that treatment literacy was developed primarily by grassroots community networks in the global South, linking TAC in solidarity with other Southern organizations such as the Lawyer's Collective (India), Global Network of PWA (Thailand), Brazilian Interdisciplinary AIDS Association (ABIA) (Brazil), and international organizations and agencies such as Oxfam and Médecins Sans Frontières (MSF) [31].…”

Section: Resultsmentioning

confidence: 99%

Prevention literacy: community‐based advocacy for access and ownership of the HIV prevention toolkit

Parker

Perez-Brumer

García

et al. 2016

Journal of the International AIDS Society

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IntroductionCritical technological advances have yielded a toolkit of HIV prevention strategies. This literature review sought to provide contextual and historical reflection needed to bridge the conceptual gap between clinical efficacy and community effectiveness (i.e. knowledge and usage) of existing HIV prevention options, especially in resource-poor settings.MethodsBetween January 2015 and October 2015, we reviewed scholarly and grey literatures to define treatment literacy and health literacy and assess the current need for literacy related to HIV prevention. The review included searches in electronic databases including MEDLINE, PsycINFO, PubMed, and Google Scholar. Permutations of the following search terms were used: “treatment literacy,” “treatment education,” “health literacy,” and “prevention literacy.” Through an iterative process of analyses and searches, titles and/or abstracts and reference lists of retrieved articles were reviewed for additional articles, and historical content analyses of grey literature and websites were additionally conducted.Results and discussionTreatment literacy was a well-established concept developed in the global South, which was later partially adopted by international agencies such as the World Health Organization. Treatment literacy emerged as more effective antiretroviral therapies became available. Developed from popular pedagogy and grassroots efforts during an intense struggle for treatment access, treatment literacy addressed the need to extend access to underserved communities and low-income settings that might otherwise be excluded from access. In contrast, prevention literacy is absent in the recent surge of new biomedical prevention strategies; prevention literacy was scarcely referenced and undertheorized in the available literature. Prevention efforts today include multimodal techniques, which jointly comprise a toolkit of biomedical, behavioural, and structural/environmental approaches. However, linkages to community advocacy and mobilization efforts are limited and unsustainable. Success of prevention efforts depends on equity of access, community-based ownership, and multilevel support structures to enable usage and sustainability.ConclusionsFor existing HIV prevention efforts to be effective in “real-world” settings, with limited resources, reflection on historical lessons and contextual realities (i.e. policies, financial constraints, and biomedical patents) indicated the need to extend principles developed for treatment access and treatment literacy, to support prevention literacy and prevention access as an integral part of the global response to HIV.

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Section: Resultsmentioning

confidence: 99%

Prevention literacy: community‐based advocacy for access and ownership of the HIV prevention toolkit

Parker

Perez-Brumer

García

et al. 2016

Journal of the International AIDS Society

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“…Ray and co-authors [114] argue that “failure to reduce preventable maternal deaths represents a violation of women’s right to life, health, non-discrimination and equality.” They advocate an activist approach, involving collaboration of health professionals and non-government civil organizations for improving material health in the African context. As a model for such an initiative, they point to grassroots HIV activism and its successful rights-based challenge.…”

Section: Resultsmentioning

confidence: 99%

“…As a model for such an initiative, they point to grassroots HIV activism and its successful rights-based challenge. Thus, they note: “With regard to maternal mortality, where the majority of deaths are preventable and in many countries occur in health institutions, there are opportunities to learn from the successes of HIV campaigns in making health services more responsible to women’s needs [114]”. As an example of this kind of activism in women’s health, they point to the Treatment Action Campaign in South Africa, which used a right to health approach, community empowerment, popular mobilization, and legal action.…”

Section: Resultsmentioning

confidence: 99%

Development, coinfection, and the syndemics of pregnancy in Sub-Saharan Africa

Singer

2013

Infect Dis Poverty

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Notable among gaps in the achievement of the global health Millennium Development Goals (MDG) are shortcomings in addressing maternal health, an issue addressed in the fifth MDG. This shortfall is particularly acute in Sub-Saharan Africa (SSA), where over half of all maternal deaths occur each year. While there is not as yet a comprehensive understanding of the biological and social causes of maternal death in SSA, it is evident that poverty, gendered economic marginalization, social disruptions, hindered access to care, unevenness in the quality of care, illegal and clandestine abortions, and infections are all critical factors. Beyond these factors, this paper presents a review of the existing literature on maternal health in SSA to argue that syndemics constitute a significant additional source of maternal morbidity and mortality in the region. Increasing focus on the nature, prevention, and treatment of syndemics, as a result, should be part and parcel of improving maternal health in SSA.

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“…Several authors underlined the importance of some contextual factors necessary to enable the harmonious implementation and smooth running of social accountability, which are lacking in these health zones, such as the existence of a coalition and social mobilization [26, 28, 33, 35, 40–44]. Other authors stressed the importance of the capacity of community groups to express their views or to exert pressure on health providers or on the public authorities [45, 46], a well-functioning health committee [45, 47] especially considering the limited influence of health providers [48, 49], competent decentralization [45, 50], and the role of the media in providing access to information [28] as enabling factors of social accountability.…”

Section: Discussionmentioning

confidence: 99%

Understanding the local context and its possible influences on shaping, implementing and running social accountability initiatives for maternal health services in rural Democratic Republic of the Congo: a contextual factor analysis

Mafuta

Hogema

Mambu

et al. 2016

BMC Health Serv Res

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BackgroundSocial accountability has to be configured according to the context in which it operates. This paper aimed to identify local contextual factors in two health zones in the Democratic Republic of the Congo and discuss their possible influences on shaping, implementing and running social accountability initiatives.MethodsData on local socio-cultural characteristics, the governance context, and socio-economic conditions related to social accountability enabling factors were collected in the two health zones using semi-structured interviews and document reviews, and were analyzed using thematic analysis.ResultsThe contexts of the two health zones were similar and characterized by the existence of several community groups, similarly structured and using similar decision-making processes. They were not involved in the health sector’s activities and had no link with the health committee, even though they acknowledged its existence. They were not networked as they focused on their own activities and did not have enough capacity in terms of social mobilization or exerting pressure on public authorities or providers.Women were not perceived as marginalized as they often occupied other positions in the community besides carrying out domestic tasks and participated in community groups. However, they were still subject to the local male dominance culture, which restrains their involvement in decision-making, as they tend to be less educated, unemployed and suffer from a lack of resources or specific skills.The socio-economic context is characterized by subsistence activities and a low employment rate, which limits the community members’ incomes and increases their dependence on external support.The governance context was characterized by imperfect implementation of political decentralization. Community groups advocating community rights are identified as “political” and are not welcomed. The community groups seemed not to be interested in the health center’s information and had no access to media as it is non-existent.ConclusionsThe local contexts in the two health zones seemed not to be supportive of the operation of social accountability initiatives. However, they offer starting points for social accountability initiatives if better use is made of existing contextual factors, for instance by making community groups work together and improving their capacities in terms of knowledge and information.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1895-3) contains supplementary material, which is available to authorized users.

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Activism: working to reduce maternal mortality through civil society and health professional alliances in sub-Saharan Africa

Cited by 30 publications

References 21 publications

Prevention literacy: community‐based advocacy for access and ownership of the HIV prevention toolkit

Prevention literacy: community‐based advocacy for access and ownership of the HIV prevention toolkit

Development, coinfection, and the syndemics of pregnancy in Sub-Saharan Africa

Understanding the local context and its possible influences on shaping, implementing and running social accountability initiatives for maternal health services in rural Democratic Republic of the Congo: a contextual factor analysis

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