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The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries.
The world-wide importance of malaria in restricting economic growth, labor productivity and social progress in many less developed portions of the world and A.I.D.'s past, present and future role in the control of this disease is briefly reviewed. In developing its future role in a changing and dynamic setting, the A.I.D. has developed and established new policies for malaria control which interlink more closely with the Primary Health Care systems and directly relate, in many cases, to other A.I.D. health projects in child survival. These new policies and criteria are summarized. A review of the three emphasis areas of research, training and program design is provided. Intersectorial coordination is stressed as is cooperation in its assistance efforts with multilateral and other bilateral agencies in combatting this disease. The paper concludes that malaria remains an important health interest of the A.I.D. and support for technology development, transfer and adaptation is expected due to the economic and social importance of the disease.
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The Albanian Forum of Public Health (AFPH), an umbrella organization including different public health associations operating in Albania, was established in March 2004 with the support of the European Public Health Association (EUPHA) and the Open Society Institute (OSI). Ever since its establishment the AFPH has been an open arena wherein opinions and options for rational health policies comprising all relevant issues of the New Public Health are discussed, formulated, and documented near the Albanian Ministry of Health. Notwithstanding the laudable mission of the AFPH, there is an emerging need to establish a regional Public Health Forum in south-east Europe as a basic prerequisite for sustainable development of public health in these countries. Most conveniently, this regional umbrella organization should have a supporting Secretariat based in one of the south-east European countries. Nevertheless, there is a clear call for international funding with participation of different agencies and bodies (OSI, EUPHA, Canadian International Development Agency, and the Stability Pact). A regional association in the south-east Europe would enable the organization of annual conferences in the most renowned institutions in the region. Also, a regional collaboration among public health associations would be a suitable start for the development of research in south-east Europe. Furthermore, the existence of a regional public health association would make feasible the establishment of a scientific public health journal for south-east Europe in the English language.
Ill health is a serious impediment to progress in most poor countries, yet health is not a high priority on foreign aid agendas. Health research, which provides the essential base for sustainable progressive health programs, is barely visible in developing countries. For example, in Bangladesh, one finds unacceptably high morbidity and mortality rates among infants and children, health programs that are struggling and a rudimentary health research establishment; for the huge foreign donor community in that country, health programs and research do not appear to warrant major investments. Diarrheal diseases are at the top of the list of killers in many poor nations including Bangladesh. Recent advances in our understanding of diarrhea suggest that when prevention may not be possible soon, improved active treatment can evolve from an aggressive research effort centered in a developing country and linked to appropriate international partners. Global agencies such as the World Health Organization have demonstrated a declining interest in health research, as reflected in the policies of their Diarrhoeal Disease Control Programme. Major donors to the developing world, the Canadian International Development Agency for example, have had a relatively minor involvement in health and little commitment to health research. University links with the west, private enterprises and specially targeted programs are involved in developing world health research but they have not been able to foster and leave behind sustainable, high quality research programs. The problem should be attacked directly by supporting focused, relevant health research centres in regions of the world where the burden of disease continues to impede progress and where the environment is conducive to high quality research that is well integrated with care delivery programs. An instructive model of this approach is the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.
In the past decade, the scarcity of financial resources for the health sector has increasingly led countries to take stock of national health resources used, review allocation patterns, assess the efficiency of existing resource use, and study health financing options. The primary difficulties in undertaking these analyses have been 1) the lack of information on health expenditures and 2) not using existing information to improve the planning and management of health sector resources. The principle sources of available health expenditure information are reported by organizations such as the World Bank, WHO, UNICEF and OECD. Special studies and non-routine information are a second major source of information. This existing data has a number of difficulties, including being sporadic, inconsistency, inclusion of only national level public expenditure, high opportunity and maintenance costs, quantitative and qualitative differences across countries, and validity and interpretability problems. Reliable health expenditure data would be useful not only for in-country, national purposes, but also for cross-national comparisons and for development agencies. Country uses of health expenditure data include policy formulation and planning and management, while international uses would facilitate examination of cross-national comparisons, reviews of existing programmes and identification of funding priorities. Collaborative efforts between countries and international development agencies, as well as between agencies, are needed to establish guidelines for health expenditure data sets. This development must ensure that the resulting information is of direct benefit to countries, as well as to agencies. Results of such collaborative efforts may include a set of standardized methodologies and tools; standardized national health accounts for developing countries; and training to enhance national capabilities to actively use the information. The opportunities for such collaboration are unique with the issuance of the World Development Report 1993, to build on this work in clearly identifying what is needed and proposing a standardized data set and the tools necessary to regularly and economically gather such data.
This article serves as an introduction to this special issue, "China's Forest Carbon Sequestration", representing major results of a project sponsored by the Canadian International Development Agency and the Chinese Academy of Sciences. China occupies a pivotal position globally as a principle emitter of carbon dioxide, as host to some of the world's largest reforestation efforts, and as a key player in international negotiations aimed at reducing global greenhouse gas emission. The goals of this project are to develop remote sensing approaches for quantifying forest carbon balance in China in a transparent manner, and information and tools to support land-use decisions for enhanced carbon sequestration (CS) that are science based and economically and socially viable. The project consists of three components: (i) remote sensing and carbon modeling, (ii) forest and soil assessment, and (iii) integrated assessment of the socio-economic implications of CS via forest management. Articles included in this special issue are highlights of the results of each of these components.
Presented here is a critical analysis of some of the major theses of Amartya Sen, as presented in his seminal work Development As Freedom. The author suggests that Sen's work, while representing a major break with the dominant neoliberal position reproduced in most national and international development agencies, is insufficient to explain the key relationship between freedom and development. The absence of an analysis of the power relations that cause and reproduce underdevelopment through national and international political institutions leaves Sen's work wanting. The author shows how Sen's interpretation of events and the conclusions derived from them, such as an explanation of famine in Bangladesh, are insufficient--when not faulty. The author also critically analyzes the United Nations Development Program reports, which, while documenting the nature and consequences of underdevelopment, barely touch on the political context in which underdevelopment occurs.
A collaborative education program between Schools of Nursing at the Jordan University of Science and Technology and the University of Windsor, funded by the Canadian International Development Agency (CIDA), provides advanced clinical and theoretical education for Jordanian faculty and thus enriches the education of nursing students. This article describes the preparation of the faculty development proposal and the implementation of the project in a transcultural context, and identifies strengths and limitations of the project. Recommendations for effective strategies regarding international development in nursing education are made and a discussion of the benefits that ensued to both faculties is included.
BACKGROUND: Since the development of the Commonwealth's 1950 Colombo Plan (Canada's first official aid program), health-related development assistance has been an important instrument of Canadian foreign policy, allowing it to gain a presence in a range of countries and help to shape international affairs. This pattern is evident in the history of Canadian multilateral and bilateral health aid to Latin America. METHODS: This analysis draws on historical material from the Departments of External Affairs and National Health and Welfare held at the Library and National Archives of Canada regarding Canadian involvement with the Pan American Health Organization (PAHO), and program information from the Canadian International Development Agency's (CIDA) Corporate Reporting Services Group. FINDINGS: Canada was initially a tentative player in the region. However, as Canadian foreign policy interests shifted towards the region in the 1970s, Canada used both multilateral and bilateral health aid to establish a presence in Latin America that was independent from, yet unthreatening to, United States hegemony in the region. CONCLUSION: The impact of Canada's provision of health aid to Latin America via PAHO and CIDA has been largely symbolic, allowing Canada to pursue an independent foreign policy in the region and to foster a positive international image for itself with minimal spending.
The Schools of Nursing of Tianjin Medical College and the University of Ottawa have been partners in a Canadian-Chinese linkage project funded by the Canadian International Development Agency (CIDA) and the Chinese Government since 1989, at teh instigation of Canadian faculty member Nancy Johnson who saw the need for academic support for the Chinese nursing community.
Community health nursing in China is an emerging specialty. A multi-component collaborative endeavor between the Schools of Nursing of Tianjin Medical University, China, and the University of Ottawa, Canada is described. This project, funded by the Canadian International Development Agency, commenced in 1989. It has laid the groundwork for an expanded role for community health nurses in Tianjin, a municipality of 11 million people located in Northeast China. The historical context for the evolution of community health nursing in China and the emergence of community health nursing as a priority area within the project are described. Major project activities are highlighted, illustrating several underlying principles for strengthening the educational preparation of baccalaureate nurses who can apply community health skills. These include creating a critical mass of faculty who can teach community health nursing, modelling classroom and clinical teaching of community health nursing, bridging the gap between nursing in the community and nursing, in the hospital, and developing a prototype for baccalaureate community health nursing experience. Lessons learned from this initiative are summarized.
The purpose of the present study was to describe the production of Dental Therapists and Assistant Dental Officers trained in Ministry of Health institutions in Tanzania during more that ten years of support from the Danish International Development Agency (Danida) through the Tanzania-Danida Dental Health Programme and to investigate their distribution and location. A total of 169 Dental Therapists and 38 Assistant Dental Officers have been trained from 1981 to 1993, representing more than 70% of the training capacity of the schools for training of oral health personnel under Ministry of Health. The distribution of both Dental Therapists and Assistant Dental Officers according to working station was, however very similar to that found before the Danida support began. Two out of every three Dental Therapists in government service were stationed in district clinics or non-government clinics at the district level. The same was true for one out of every three Assistant Dental Officers. It is concluded, that the intentions laid down in Tanzania's National Plan for Oral Health 1988-2002 of first staffing the district hospitals and, later on, the health centres with Dental Therapists have not yet been fulfilled.