Thursday, 12 July 2012

KNOTS blogger

KNOTS blogger

Tackling unregulated health markets

Posted: 12 Jul 2012 07:32 AM PDT

In a new Nature article, IDS researchers argue that rapidly expanding informal health care services can and must be improved.

Pastoralism: the hidden story of development in the Horn of Africa

Posted: 12 Jul 2012 03:54 AM PDT

Our new book Pastoralism and Development in Africa: Dynamic Change at the Margins explores the hidden story of pastoralism in the Horn of Africa. The latest volume in our Pathways to Sustainability book series, it contains 20 chapters on empirical research on the current state of pastoralism; it is edited by Andy Catley, Jeremy Lind and Ian Scoones.

Katherine Homewood is professor of Human Ecology at UCL. She has written a review of the book and has allowed us to reproduce it in full here.

Pastoralism and Development in Africa drives home the tremendous scale and pace of change in northeast African pastoralism. It has its finger spot on the pulse, tracking unfolding events up to the weeks and months before publication, and grounded in authoritative knowledge of general context as well as incisive analysis of social and historical particularities. The subject matter spans resources and production, commercialisation and markets, land and conflict, established and emerging alternative livelihoods. Chapters range from overviews by internationally renowned 'elder statesmen' social scientists (African and other), through to new voices from a rising generation of young African researchers and development practitioners, ably expounding the issues facing the pastoralist societies from which they themselves come, within which and for which they work.

The book brings alive the way this seemingly remote and notoriously volatile region, with its rapid and violent shifts in socio-political and biophysical environments, connects at all levels with national and international arenas, policies and economic flows. It traces the multiple and divergent directions of pastoralist enterprise, the risks run and opportunities seized, the striking innovations developed alongside robust, tried and tested strategies being maintained, and the successful diversification for some as against spiralling impoverishment for others. The book conveys the vigour, dynamism and adaptability of these arid and semi arid land populations, and their ability to embrace and exploit change, in a context of policies that too often constrain rather than enable.

The editors' fast-paced, highly charged first chapter is a must-read, as are the thought provoking chapters on irrigation (Sandford, Behnke and Kerven); and the entire, forceful, incisive section on land grab (Galaty, Nunow, Letai and Lind, Babiker etc). The alternative livelihoods chapters range from state of knowledge overview (eg. Livingstone and Ruhindi on women and economic diversification) to real eye-openers on emerging possibilities (eg. education: Siele, Swift and Kr├Ątli). Every chapter brings something new to the mix.

This book is not only an urgent and invigorating addition to the pastoralist development canon: it is a shot in the arm for all those concerned with pastoralism and the Horn of Africa: researchers, students, practitioners, policymakers, donor agencies and hopefully government will all learn from and make use of it.

Buy the book 

Pastoralism and Development in Africa: Dynamic Change at the Margins
Earthscan / Routledge, July 2012
Paperback, £24.95 GBP
Order online

Related articles

Health markets: Gerry Bloom and David Peters in Nature

Posted: 12 Jul 2012 03:28 AM PDT

Gerry Bloom, STEPS health convenor and David Peters (Johns Hopkins Bloomberg School of Public Health) have a comment piece in Nature today, on the challenge of unregulated health markets in the developing world.

"Bringing order to unruly health markets is a major challenge. Yet the problem is largely ignored by governments and international agencies. The World Health Organization (WHO) continues to highlight a shortage of primary health workers as the main barrier to accessing health care in low- and middle-income countries. It neglects the growing presence of drug sellers, rural medical practitioners and other informally trained health-care providers. 

To find better ways to meet the health and welfare needs of the poor, we need to look beyond ideological debates about public and private sectors and improve how these evolving markets operate. This will not be easy, because health markets are complicated and interventions have unpredictable consequences..."

This article comes ahead of the book Transforming Health Markets in Asia and Africa: Improving quality and access for the poor, which will be out in the STEPS Centre's Pathways to Sustainability book series.

Tackling unregulated health markets

Posted: 11 Jul 2012 08:45 AM PDT

A village doctor in the Sundarbans of West Bengal, India poses at his clinic.

Unregulated health markets have spread rapidly in low- and middle-income countries, in most cases faster than regulatory frameworks to ensure quality of care and equity in access. Yet international bodies like the World Health Organisation continue to ignore these actors, researchers from the Future Health Systems consortium argue in a new commentary in Nature.

In the first five-year phase of the Future Health Systems Research Consortium, country studies in Bangladesh, India and Nigeria highlighted the importance of these informal providers, variously referred to as ‘village doctors’, ‘rural medical practitioners’, ‘patent medicine vendors’. In Chakaria, a rural area of Bangladesh, ICDDR,B researchers found that these informally trained ‘village doctors’ are often the first port of call for the poor.

Transforming Health Markets is now available for pre-orderCross-country findings from FHS studies have been compiled in forthcoming book, Transforming Health Markets in Asia and Africa: Improving quality and access for the poor, which is now available for pre-order.

In the Nature commentary, the authors argue that the services provided by these informal providers can and must be improved. Recognizing that health markets represent complex adaptive systems, they argue that bringing order to unregulated markets will take more than singular interventions. Indeed, a recent book published by FHS Bangladesh, Doctoring the Village Doctors: Giving Attention Where it is Due, provides a candid reflection of the difficulties they experienced in trying to improve the services of these village doctors.