Providing medical support to the local population during a chronic crisis is difficult. The crisis in the Democratic Republic of the Congo (DRC), which is characterized by high excess mortality, ongoing armed violence, mass forced displacement, interference by neighboring countries, resource exploitation, asset stripping, and the virtual absence of the state, has led to great poverty and a dearth of funds for the support of the health system.
International nongovernmental organizations (NGOs) have stepped in to address the dire humanitarian situation. This study looks at four organizations that support local health care in the eastern DRC: the International Rescue Committee (IRC), Malteser, Medical Emergency Relief International (Merlin), and the Association Régionale d'Approvisionnement en Médicaments Essentiels (ASRAMES). The study makes a comparison of the management and financing approaches of these four organizations by collecting and comparing qualitative and quantitative data on their interaction with the (remaining) local health providers and the local population.
Specific objectives of the study are:
1. To identify which management and financing approaches, including the setting of fees, are used by the four NGOs supporting healthcare in the eastern DRC. 2. To determine how these financing approaches affect utilization rates in the health zones supported by the four NGOs. 3. To assess how these utilization rates compare with donor and humanitarian standards. 4. To determine at what level fees must be set to allow for cost recovery or cost sharing in health facilities. 5. To identify the managerial problems confronting the four NGOs.
Many epidemiological and public health studies focus on the interaction between health providers and target groups. Supporting Local Health Care in a Chronic Crisis: Management and Financing Approaches in the Eastern Democratic Republic of the Congo concentrates more on how the relationship between the supporting NGOs and the local health system actually develops. In addition, a common aspect of many of the epidemiological and public health studies is the search for an optimal, or at least appropriate, management and financing approach.
More than simple cases of dieting gone awry, eating disorders such as anorexia and bulimia are among the most fatal of mental illnesses, responsible for more deaths each year than any other psychiatric disorder. These illnesses afflict millions of young people, especially women, all over the world. Carrie Arnold developed anorexia as an adolescent and nearly lost her life to the disease. In Next to Nothing, she tells the story of her descent into anorexia, how and why she fell victim to this mysterious illness, and how she was able to seek help and recover after years of therapy and hard work. Now an adult, Arnold uses her own experiences to offer practical advice and guidance to young adults who have recently been diagnosed with an eating disorder, or who are at risk for developing one. Drawing on the expertise of B. Timothy Walsh, M.D., one of America's leading authorities on eating disorders, she reveals in easy-to-understand terms what is known and not known medically about anorexia and bulimia. The book covers such difficult topics as how to make sense of a diagnosis, the various psychotherapies available to those struggling with an eating disorder, psychiatric hospitalization, and how to talk about these illnesses to family and friends. The result is both a compelling memoir and a practical guide that will help to ease the isolation that an eating disorder can impose, showing young people how to manage and maintain their recovery on a daily basis. Part of the Adolescent Mental Health Initiative series of books written specifically for teens and young adults, Next to Nothing will also be a valuable resource to the friends and family of those with eating disorders. It offers much-needed hope to young people, helping them to overcome these illnesses and lead productive and healthy lives.
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