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1. Overcoming silos for One Health: key determinants of One Health governance platforms in low- and lower middle-income countries

Author:
Christoph Strupat
Publication Date:
01-2025
Content Type:
Working Paper
Institution:
German Institute of Development and Sustainability (IDOS)
Abstract:
This study addresses a critical gap in One Health governance literature by providing a comprehensive review of cross-sectoral One Health governance platforms in low- and lower-middle-income countries across Asia and Africa. These platforms are pivotal for building resilience and improving governance at the human–animal–environment interface. Using a scoping review methodology, the study identifies 34 One Health platforms established across 52% of these countries, with a primary focus on zoonotic diseases and a growing emphasis on antimicrobial resistance and food safety. A polycentric governance lens was applied to analyse the interplay of authority, resources and information in shaping platform functionality. Key findings highlight that authority imbalances and single-sector dominance undermine stakeholder engagement, insufficient financial and human resources hinder operational capacity. Further­more, weak data-sharing protocols limit timely coordination and evidence-based decision-making. The review identifies critical entry points for enhancing platform efficacy: clarifying governance frameworks, investing in cross-sectoral human capacity-building and strengthening data-sharing infrastructures with robust protocols and interoperable platforms.
Topic:
Development, Governance, and Public Health
Political Geography:
Africa and Asia

2. The Partograph: A Tool to Reduce Mother-Child Mortality Rate During Labour

Author:
Fobella Nkengafac, Regina Sinsai, Ghyslaine Bruna Djeunang Dongho, Solange Dabou, Evrard Kepgang, and Ronald Gobina
Publication Date:
11-2024
Content Type:
Working Paper
Institution:
The Nkafu Policy Institute
Abstract:
The Safe motherhood initiative is a fundamental aspect of healthcare that was launched in 1987 with an aim to reduce maternal mortality and ensure positive birth outcomes in developing countries(1) [1]. In many parts of the world, women face numerous challenges during childbirth. As a result, maternal and child mortality remains a global concern as the rates continue to remain high with more than 69% of maternal deaths occurring in African countries with rates ranging between 500 and 999 deaths per 100 000 live births (2) [2]. These elevated rates of maternal mortality are generally attributed to complications that arise, during pregnancy, before birth, during birth or after birth, and are commonly avoidable through appropriate interventions. WHO set as part of the 2030 Sustainable Development Goals (SDG), to reduce maternal deaths to 70 maternal deaths per 100 000 live births (1) [1]. Despite significant progress in healthcare, complications during labour and delivery continue to contribute to a substantial number of preventable deaths. The partograph, a simple yet effective tool, has shown promising results in reducing these mortality rates during labour. Yet, its use remains relatively low in some medical facilities in Cameroon (2,3) [2,3]. This article aims to shed light on the importance of the partograph, its role in improving maternal and child health outcomes and highlights its role in reducing complications during labour.
Topic:
Women, Public Health, Healthcare System, and Infant Mortality
Political Geography:
Africa and Cameroon

3. Health for everyone, everywhere?

Author:
Lionel Osse Essima and Matthias Krönke
Publication Date:
04-2024
Content Type:
Policy Brief
Institution:
Afrobarometer
Abstract:
The theme of World Health Day 2024 (7 April) is “My health, my right” (World Health Organization, 2024). A key component of the message is to encourage governments to deliver on citizens’ right to health by making health services “available, accessible, acceptable and of good quality for everyone, everywhere.” How close are African governments to meeting this ambitious goal? Since 1990, the burden of disease has decreased substantially in Africa (Roser, Ritchie, & Spooner, 2024; also see Figure A.1 in the Appendix). Between 2000 and 2019, Africa recorded the world’s greatest growth in healthy life expectancy, which rose from 46 to 56 years (Adepoju & Fletcher, 2022). Further, between 2015 and 2021, the under-5 mortality rate fell from 87 to 74 deaths per 1,000 live births across sub-Saharan Africa (United Nations, 2023). According to the World Health Organization, these gains were achieved through increased provision of essential health services and better access to care and disease prevention services (Adepoju & Fletcher, 2022). Despite these important advances, however, many Africans still do not have access to high quality health care. Compared to other world regions, the gap is particularly acute when it comes to communicable, neonatal, maternal, and nutritional diseases (as opposed to non communicable diseases and injuries) (see Figure A.2 in the Appendix). While sub-Saharan Africa saw the world’s fastest growth between 2015 and 2022 in the proportion of births attended by skilled health personnel, from 59% to 70%, the continent also recorded about 70% of the world’s maternal deaths (United Nations, 2023). At least part of the explanation is a lack of health workers; as of 2021, sub-Saharan Africa had an average of 2.3 medical doctors and 12.6 nursing/midwifery personnel per 10,000 people, compared to 39.4 and 89.5 in Europe (United Nations, 2023).
Topic:
Education, Public Opinion, Social Services, Public Health, and Healthcare System
Political Geography:
Africa

4. The Guinea Worm, President Carter and Me: A Journey Through Health Diplomacy

Author:
Lisa Rotondo
Publication Date:
05-2023
Content Type:
Journal Article
Journal:
American Diplomacy
Institution:
American Diplomacy
Abstract:
In September 2001, just days before 9/11, I arrived in Pissila, Burkina Faso for my Peace Corps assignment. I was eager to get to work helping my new home community do surveillance for a neglected tropical disease (NTD) called dracunculiasis, or Guinea worm disease. As a Peace Corps Volunteer in rural Burkina Faso, I biked from village to village, asking community members if they were aware of anyone with Guinea worm disease, an infection that has impacted both humans and animals since ancient times. Thanks, in part, to the work of volunteers before me, I never actually saw a person with Guinea worm disease during my two years as a volunteer. Burkina Faso was on the brink of eliminating the disease, and I remember thinking that the children in my community would never know the word for Guinea worm in their language, Moorè; it would not be in their vocabulary because they would never have to worry about it. I’ve reflected on that more than once during my career in public health. Knowing that we are truly making diseases history has been the drive underlying my efforts for the last two decades.
Topic:
Diplomacy, Health, Memoir, and Public Health
Political Geography:
Africa, United States of America, and Burkina Faso

5. HIV, the Legacy of America’s Response, and Lessons for Future Outbreaks

Author:
Alisha Smith-Arthur
Publication Date:
11-2023
Content Type:
Journal Article
Journal:
American Diplomacy
Institution:
American Diplomacy
Abstract:
As I stood in line (safety distanced) to receive a COVID test before returning home to the US after a trip to Cote d’Ivoire in 2022, I was able to see and reflect upon the enduring legacy of the American public health diplomacy effort to fight the global pandemic of HIV. The testing site had the unmistakable dual-flag PEPFAR (The President’s Emergency Plan for AIDS Relief, announced by George W. Bush in 2003) logo outside, indicating that the testing equipment (and likely the training for the personnel inside) came via a PEPFAR project. I’ve seen similar stamps on rural labs and remote health posts across the countries I’ve worked in (as well as on the airport welcome signs of many a friendly health worker who has readily included me in their work), and it always serves to remind me of the common goals we are working towards in these health diplomacy projects.
Topic:
HIV/AIDS, Diplomacy, Public Health, and COVID-19
Political Geography:
Africa, North America, and United States of America

6. Fixing Ghana’s Non-Existent Adult Social Care System

Author:
Sarpong Aseidu and Adjei Boakye
Publication Date:
04-2023
Content Type:
Policy Brief
Institution:
Ghana Center for Democratic Development
Abstract:
Following Ghana’s announcement that an Internaonal Monetary Fund (IMF) program was being sought to help the country go through the current economic downturn, a domesc debt exchange program (DDEP) was announced. As the DDEP progressed it became obvious that many old-age pensioners with bond investments were going to be adversely affected. This led to pickeng by some of those affected at the Ministry of Finance. Many who joined were of the view that should their funds be included, their health will be adversely affected. Though the full details of Ghana’s program with the IMF would not be known for a while, it is accepted that it will aim to address the current macroeconomic imbalances and aempt to promote sustainable economic growth. This will require the implementaon of measures that ensure fiscal and monetary reforms and prudent debt management. Such reforms either reduce subsidies or increase taxes which invariably increase the cost of living. This disproporonately affects people on a fixed income such as the elderly. In a country like Ghana where there isn’t a social safety net for the elderly, and with the cost of chronic disease medicines on the rise this could have an impact on the quality-adjusted health years (QALYs) of this segment of our population.
Topic:
Economic Growth, Aging, Public Health, IMF, and Safety Net
Political Geography:
Africa and Ghana

7. Enhancing Tobacco Control in Nigeria: The Impact of Health Warnings on Cigarette Packaging

Author:
African Capacity Building Foundation (ACBF)
Publication Date:
01-2023
Content Type:
Policy Brief
Institution:
The African Capacity Building Foundation (ACBF)
Abstract:
Tobacco consumption, a significant health issue in Nigeria, is associated with numerous deaths and has a substantial economic impact. This study examines the effectiveness of health warnings on cigarette packaging in Nigeria and their potential to reduce tobacco consumption. The findings suggest that transitioning from text-only health warnings to graphic and text warnings can lead to a significant decrease in tobacco-related deaths and diseases, and substantial savings in health costs. The study recommends that Nigeria should aim to achieve 100% compliance with its current regulations and move towards plain packaging with large warnings.
Topic:
Health, Regulation, Economy, Tobacco, and Public Health
Political Geography:
Africa and Nigeria

8. Addressing the Illicit Tobacco Trade in Senegal: Strategies for Enhancing Public Health and Economic Stability

Author:
African Capacity Building Foundation (ACBF)
Publication Date:
01-2023
Content Type:
Policy Brief
Institution:
The African Capacity Building Foundation (ACBF)
Abstract:
The illicit tobacco trade in Senegal is a significant issue, with an estimated value of over 14 billion FCFA (approx. 30 million USD), representing 0.16% of the country's GDP. This trade undermines public health policies, fiscal revenues, and fuels transnational criminal activities. The study findings highlight the need for improved border security, regular consumer behavior surveys, enhanced inter-agency communication, harmonization of tobacco taxation within the ECOWAS region, and modernization of tobacco seizure data collection.
Topic:
Tobacco, Illegal Trade, Public Health, and Economic Stability
Political Geography:
Africa and Senegal

9. Leveraging Price Elasticity to Curb Tobacco Consumption in Botswana: A Strategy for Healthier Outcomes

Author:
African Capacity Building Foundation (ACBF)
Publication Date:
01-2023
Content Type:
Policy Brief
Institution:
The African Capacity Building Foundation (ACBF)
Abstract:
Tobacco consumption remains a significant public health concern in Botswana, with existing policies failing to effectively reduce its prevalence. The study "Responsiveness of Cigarette Demand to Price Changes in Botswana" reveals that a 10% increase in the price of cigarettes leads to an 8.6% decrease in demand among smokers, providing crucial insights for policy formulation. Based on these findings, it is recommended that policy changes focus on increasing taxes on tobacco products, with the additional revenue invested in health programs aimed at further reducing tobacco use and improving public health outcomes.
Topic:
Tobacco, Public Health, and Price
Political Geography:
Africa and Botswana

10. Optimising Tobacco Taxation in Mauritania: A Strategy for Health Improvement and Revenue Generation

Author:
African Capacity Building Foundation (ACBF)
Publication Date:
01-2023
Content Type:
Policy Brief
Institution:
The African Capacity Building Foundation (ACBF)
Abstract:
The issue of tobacco consumption in Mauritania is of significant public health concern. The current taxation system is ineffective in reducing consumption and maximizing state revenue. The study “Optimal Tobacco Taxation in Mauritania” found that the system has led to significant revenue loss due to under-declared customs values and the application of VAT at the customs level rather than at the point of sale. The introduction of an excise tax based on the quantity of tobacco products imported is recommended. This would help to increase the price of cigarettes, thereby reducing consumption, and would also generate significant revenue for the state.
Topic:
Tax Systems, Tobacco, Public Health, and Revenue
Political Geography:
Africa and Mauritania