In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their healt
...
h care. Salaries were not paid for more than
six months and life for the general population was very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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revised version December 2020
Human rights-based approaches to the creation of knowledge involve application of human rights principles to both the content and process of knowledge creation. Human rights-based approaches have special significance for the sexual
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and reproductive health and rights (SRHR) of all people, in particular for women and girls, people living with disability, lesbian, gay, bisexual, trans, queer or Intersex (LGBTQI) populations, refugees, migrants and other marginalised populations.
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This Handbook is primarily for educators, to help them learn about mental health issues and better support them in educational environments. The Handbook aims to provide training to teachers, admini
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strators, and people involved in the education of primary school children about the implementation of mental health literacy into daily school life. Such knowledge, skills and attitudes will equip all levels of educators with key tools to support student mental health, manage difficult classroom behavior, and promote students’ wellbeing and academic success.
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Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Develo
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pment Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries have a legal obligation to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
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This handbook follows a comprehensive approach to health system strengthening at borders in order to support IHR national focal points and other national agencies in developing
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and implementing evidence-based action plans for IHR capacity development at ground crossings. The approach includes the movement of travellers and baggage, cargo, containers, conveyances, goods and postal parcels across ground crossings, as well as the interaction with adjacent border communities. Other factors can be considered, if needed, throughout the risk assessment.
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Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-
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health including disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
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The paper sets out the specific communication challenge posed by Ebola and why it was so difficult to get to grips with this in the early months of the outbreak. It thendocuments when the health com
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munication response became more useful and explores what that tells us about effective media and communication. Finally, it offers recommendations to ensure that media and communication are used to their full potential during other disease outbreaks and humanitarian crisis
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Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing th
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e worst effects as they are most vulnerable to climate shifts and least able to adapt given weak health systems and poor infrastructure. Low-carbon approach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and con
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trol (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi,
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and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in refugee settlements in northern and southwestern Uganda, and in Kampala City. Thirteen districts accommodate 94% of these refugees.
The World Health Organization (WHO) and Uganda’s Ministry of Health conducted a joint review mission to provide a comprehensive overview of the health system's response. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening health system capacity and ensuring continued access to health services for refugees, migrants and host communities.
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COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, w
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e calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.
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A guidance document in simple language for health personnel, setting out their rights and responsibilities in conflict and other situations of viol
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ence. It explains how responsibilities and rights for health personnel can be derived from international humanitarian law, human rights law and medical ethics.The document gives practical guidance on:
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