Search PubMed⌕ Search

Biomedical subjects

D Yach

Publications and source records attributed to D Yach.

At least 55 records · Page 3Linked to original sources
PubMed1994

All Africa conference on tobacco control.

Although the health hazards of smoking are now generally accepted in most Western countries, the arguments have not had much impact on poorer nations. A conference on tobacco control held in Harare, Zimbabwe, in November last year was the largest to tackle this problem. The conference heard how threats of epidemics of tobacco related disease in the distant future held little weight with governments of countries that often already had massive public health problems. More immediate effects needed to be emphasised. Speakers gave three cogent arguments; firstly, the loss of capacity for foreign trade in essential goods, since most African countries are net importers of tobacco; secondly, the extensive deforestation which is occurring to fuel the flue curing of tobacco; thirdly, evidence from Papua New Guinea that raising taxation on tobacco provides governments with increased income for many years before a decrease begins.

Africa↗
PubMed1994

Tobacco advertising in South Africa with specific reference to magazines.

RATIONALE: A ban on tobacco advertising forms an integral component of tobacco control strategies, and needs to be considered in South Africa as a matter of urgency. OBJECTIVES: To obtain baseline data on tobacco advertising expenditure in the South African media, and to compare brands used to target different groups in magazines. METHODS: Advertising expenditure (totals and tobacco-related) for 1991 and 1993 was obtained from Adindex. Ten magazines, each with circulations of over 100,000, directed at four different target groups, were selected. For 3 months in 1993, total and tobacco advertising expenditure, brand placement and magazine demographics were determined. RESULTS: Tobacco-related expenditure constituted 4.8% of the R3 billion spent on advertising in 1993. Print (including magazines) and radio together accounted for 72% of all tobacco advertising, while cinema and outdoor advertising were most dependent on the tobacco industry for revenue. Annualised advertising spending for the 10 magazines reached an estimated R230 million, of which tobacco 'adspend' accounted for 6.4%. The highest percentage of tobacco adspend (20.3%) was for a men's 'soft-porn' magazine. For 26 of 30 issues studied, tobacco adverts were on the back cover. Brand targeting was evident in black, women's, and family magazines. There was not a single feature article on the adverse effects of smoking on health in any of the magazines during the 3-month period. Only 2 magazines had single sentences in their health columns mentioning that smoking was bad for health. In a third magazine, one opinion piece devoted a full page to criticising the anti-tobacco lobby! CONCLUSION: Tobacco advertising, through radio and outdoor advertising, reaches children and illiterate communities in peri-urban and rural areas. Tobacco advertising in magazines targets specific consumers, such as blacks and women. For most magazines, tobacco adspend constitutes less than 10% of the total. A total ban on tobacco advertising in the media in general and certainly in magazines would not have adverse economic effects and would promote health.

Advertising↗
PubMed1994

Smoking in the black community of the Cape Peninsula, South Africa.

The purpose of this study was to determine tobacco-use and related factors in the black population of the Cape Peninsula. About 52% of the men, but only 8% of the women used tobacco regularly. Men and women who smoked cigarettes, smoked 9.6 and 4.3 cigarettes on average per day, respectively. Although many men smoked, 80% perceived smoking to be harmful to health as did 92% of the women. For women, smoking was inversely related to their level of education, while for men it was directly related to being employed. Smoking was also related to the use of alcohol in both genders. Women below 45 years who had spent less than a third of their lives in the city had lower smoking rates than those who had spent more than a third of their lives in the city. Smoking is one of the most important public health issues facing the black community of the Cape Peninsula.

Adolescent↗
PubMed1994

Towards a higher priority for health on the development agenda.

Over the last few years major international agencies (particularly the World Health Organisation and the World Bank) have increasingly recognised that investing in health is crucial for development. Development policies have the potential to enhance or impede progress in achieving Health for All. At the macro-economic level it is broadly recognised that the state of the economy of a country has a strong influence on its health level. The growing number of the population below the poverty line in sub-Saharan Africa is expected to have a substantial impact on health in the future. Further, structural adjustment programmes' impact on health has yet to be adequately evaluated. Rapid population growth in sub-Saharan Africa needs to be innovatively addressed as a matter of extreme urgency. The education of women is strongly related to child survival. Over the next few years the prospects for global disarmament are increasing. Options for using both the technology, financial savings, and personnel for improving health need to be investigated. A broader range of policy options for health needs to be considered by governments. A greater focus on information, education, and communication for health is needed that draws upon both the private and the public sector; greater use of regulation and legislation as solid policy instruments, for example, for pollution control, and banning tobacco and alcohol advertising, is required. Financial strategies using a combination of taxes and subsidies have not been adequately used in developing countries. The previous emphasis on urban-based expensive hospitals has proved to be inappropriate, resulting in severe inefficiency and inequity in the health systems of developing countries. Greater attention must be given to funding those areas with a high potential for positive externalities and that yield public goods. The final policy instrument involves using research to extend the options for intervention choice.

Africa South of the Sahara↗
PubMed1994

Missed opportunities for immunisation at hospitals in the western Cape--a reappraisal.

Immunisation practices were examined at 6 hospitals in the western Cape during the latter half of 1992 to determine whether these practices had improved subsequent to the February 1991 resolution of the Health Matters Committee (HMC) on immunisation in hospitals, and since a similar study was undertaken in 1990. Exit interviews were conducted with the escorts of all children aged 3-59 months who attended the study hospitals on the days designated for the study. In the second study, 88 of the 311 children studied (28.3%) were in need of immunisation on arrival, but only 12 of the 88 (13.6%) were immunised during the hospital visit. There was no evidence of an increase in requests to see children's Road-to-Health cards (37.1% compared with 35.2% previously). The incidence of missed opportunities for measles immunisation in children aged 6-59 months remained unacceptably high (51.4% compared with 63.7% previously, when a strict definition was used; and 15.7% compared with 18.1% previously, when a lenient definition was used). Health authorities at all levels need to take urgent action to address the problem of missed opportunities for immunisation at hospitals.

Child, Preschool↗
PubMed1994

A national sentinel surveillance network for the measurement of ill-health in South Africa. A prerequisite for epidemiological research and health planning.

Data on births, on deaths by cause and on morbidity are essential in planning appropriate health interventions, but the scarcity of these data in South Africa is striking. Some of the limitations of national mortality and morbidity data collection systems are reviewed. In order to improve the usefulness of vital statistical information, it is proposed that active disease monitoring be introduced in a number of surveillance sites where the population has been properly enumerated. A network of these sites would routinely gather information on births and deaths by cause and on a list of conditions that are: (i) easy to identify clinically; (ii) would bring most people to the attention of health personnel; and (iii) would indicate failure of health service provision, environmental control or resource allocation. The measurement of the geographical variation of a number of conditions, coupled with geographical information on health care indicators and risk and health promotive factors in each site, would facilitate the planning of interventions in a rational manner.

Female↗
PubMed1993

Mortality in a rural South African mission, 1837-1909: an historical cohort study using church records.

Three decadal birth cohorts (1837-1846), 1870-1879 and 1900-1909) each of approximately 500 individuals, were constructed retrospectively through the parish records of the Moravian Mission at Mamre in the Western Cape region of South Africa. Nominative data collection techniques were used to determine the infant mortality rates (IMR), quinquennial mortality rates (QMR) and life expectancies of the three cohorts. The quality of the data was investigated, specifically non-registration and attrition. Overall, male registration coverage was substantially better than that for females. Birth registration was best for the 1837-1846 cohort for males and females, with the 1900-1909 registration being next best. Infant death registration was most complete for males in these two cohorts, but was poor for females. Based on these data, the IMR for the cohorts born in 1837-1846, 1870-1879 and 1900-1909 (196, 182 and 128 per 1000 respectively for males and 160, 172 and 97 per 1000 respectively for females) appeared to be underestimates. There was some evidence of a downward trend for the IMR with time for males, but this was not statistically significant. For the three cohorts QMR did not differ statistically for males, but for females the third cohort was consistently lower than the other cohorts. The difference was small (well within the 95% confidence interval) but the third cohort ranked consistently below the other two. The life expectancies did not differ significantly between cohorts. The life expectancies at birth (range 34-40 years for males and 32-45 years for females) were probably overestimates due to biased IMR. The life expectancies at age 1 (range 41-44 for males and 37-49 for females) were considered to be more representative figures. Life expectancies at age 20 (37-45 years) were fairly stable over time except for females in the 1900-1909 cohort whose life expectancies were substantially higher than the figures for the earlier cohorts. All mortality indices investigated in this study consistently showed a lighter burden of mortality in historical Mamre compared to 'coloureds' in the Cape Colony at the turn of the century. This is probably the result of the better housing, environmental, social, economic and educational conditions on the missions relative to the rest of the Colony in the century after the emancipation of slaves.

Adult↗