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Biomedical subjects

P H Streefland

Publications and source records attributed to P H Streefland.

10 recordsLinked to original sources
PubMed2003

Introduction of a HIV vaccine in developing countries: social and cultural dimensions.

Using insights from studies on social and cultural aspects of immunization in Africa and Asia the paper discusses the introduction of a HIV vaccine from three perspectives. Firstly, it shows how at the side of public health programs local differences will impact on the introduction of a new vaccine. Secondly, it elaborates how at the side of the users of vaccinations acceptance, non-acceptance and demand of and for a new vaccine are related to local vaccination cultures, images of the HIV/AIDS epidemic, and perceptions of vaccine potency and efficacy. Thirdly, it points out socio-cultural aspects of the introductory process. Tailoring health education and social marketing to local conditions and local interpretations of globally provided information will be decisive for a successful introduction. Strong public health programs with highly motivated and appropriately supported staff are another necessary condition.

AIDS Vaccines↗
PubMed2001

Public doubts about vaccination safety and resistance against vaccination.

Immunisation is a cornerstone of preventive medicine. The prospects for continuation of this position are outstanding, since the medical intervention has been deemed as cost-effective in major publications on global disease prevention priorities. Recently, the financial foundations of global immunisation efforts have been strengthened considerably through the establishment of a large fund with a viable organisational underpinning. Routine vaccination programmes, usually known as Expanded Programme on Immunisation (EPI), now have an almost world-wide coverage. Despite high coverage levels, there have always been parents with doubts about the efficacy, safety and necessity of childhood vaccinations on offer. Although usually acceptance of vaccination was and is the general pattern, individual refusal and public resistance have been documented. This article focuses on the forms and implications of public doubts about vaccines and vaccinations in industrialised and in developing countries. Using, among other sources, material from the Social Science and Immunisation Project it explains how such reactions must be understood in context. It highlights different forms and trajectories of non-acceptance of vaccinations and discusses how policy makers and programme managers could address these issues.

Attitude to Health↗
PubMed1999

Quality of vaccination services and social demand for vaccinations in Africa and Asia.

For immunization to be effective in the long run as a major global disease control intervention it is important to provide good quality vaccination services. Studies carried out in three countries in Asia (Bangladesh, India, and the Philippines) and two countries in Africa (Ethiopia and Malawi), and reported on in this article, document the fact that parents are willing to invest considerable effort in having their children vaccinated; however, there are a number of serious shortcomings in the quality of the routine vaccination services and strains are apparent at the interface between the vaccination providers and the users. These shortcomings are detracting from the sustainability of routine vaccination programmes and are promoting the growth of pools of nonimmunized and partially immunized children. To safeguard the continued operation and to enhance the coverage of routine vaccination programmes it is crucial that these difficulties be addressed.

Adult↗
PubMed1995

Enhancing coverage and sustainability of vaccination programs: an explanatory framework with special reference to India.

The article addresses the question in what form and under what conditions vaccination programs can be expected to continue once the 'take off' period is over. This matter is of great importance because of the need to continuously vaccinate new cohorts of children with a high degree of coverage and in an appropriate manner. Using data from India, where vaccination programs are integrated in regular health care delivery, an explanatory framework is presented which, first, analyses the vaccination program in terms of different levels, organizational cultures and inner-level linkages and, second, addresses the relation between the program and its socio-cultural context. The analysis provides starting points for changes that could enhance coverage and sustainability. Such changes include alterations in program design and adjustments in the views of different categories of program staff. The article discusses strategies directed at achieving such changes.

Child↗
PubMed1993

Enhancing appropriate drug use: the contribution of herbal medicine promotion. A case study in rural Thailand.

The article presents the results of an exploratory study conducted in Thailand in 1988, comparing the results of two approaches to encourage the use of herbal medicine as a safe and cheap alternative to pharmaceuticals. The study included one government programme using a clinic-oriented approach and one non-governmental programme using a community-oriented approach. Drug use in response to illness episodes was surveyed among households in two villages covered by each programme and hospital out-patient prescription records were sampled. Herbal medicines were used to treat 14.8% and 14.0% of the illness-episodes in the villages taking part in the clinic-oriented programme and to treat 62.1% and 29.7% of the episodes in the villages covered by the community-oriented programme. Herbs are mostly used after a prior treatment with pharmaceuticals has failed. Only 12.4% of out-patient prescriptions from the hospital in the government programme included herbal drugs, compared to 47.3% of prescriptions from the hospital in the non-governmental programme. The results of the study suggest that a community-oriented approach can most effectively influence the pattern of drug use in self-care. Complementary to the community-oriented approach, the government should support efforts to change the prescribing attitude of physicians and include training in traditional medicine in medical curricula.

Community Health Services↗
PubMed1992

Preventing AIDS now.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Primary health care in a multi-level perspective: towards a research agenda.

The authors propose to view primary health care (PHC) from a multi-level perspective. Studying how PHC is conceived and implemented at different levels of social organization (e.g. in international agencies, national governments, regional centres of health care and local communities) will reveal which interests may be competing in the planning and execution of what broadly and conveniently is called 'PHC'. Mapping out these conflicting views and interests will contribute towards a better understanding of how PHC works or why it does not work and provide suggestions for a more effective and equitable PHC. Five themes are proposed for a multi-level research approach: (1) vertical versus horizontal organization of PHC: (2) the role of medical personnel in PHC; (3) the distribution of pharmaceuticals; (4) the integration of traditional medicine in PHC; and (5) family planning.

Developing Countries↗
PubMed1989

The continuity of vaccination programmes: reflections and a case from Gujarat, India.

In the wake of the successful smallpox eradication programme, immunization has become an international affair. The WHO and UNICEF promote universal immunization against six childhood diseases through the Expanded Programme on Immunization. The paper focuses on the process through which rules and procedures which have been formulated and standardized at the international level are realized at the local level, losing part of their rigidity on the way. It is pointed out that the integration of vaccination programmes in society has positive implications with regard to their continuity. On the basis of results of a field study in Gujarat, India, other approaches to enhance this continuity are also discussed.

Communicable Disease Control↗