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Biomedical subjects

R Shoo

Publications and source records attributed to R Shoo.

6 recordsLinked to original sources
PubMed2005

Availability and use of emergency obstetric services: Kenya, Rwanda, Southern Sudan, and Uganda.

UNLABELLED: The article summarises the baseline assessments of emergency obstetric care (EmOC) carried out in Uganda, Kenya, Southern Sudan, and Rwanda in 2003 and 2004. OBJECTIVES: Our objectives were to: (1) set up program baselines on the availability and utilization of EmOC services in these countries; (2) identify gaps and obstacles in providing EmOC services; and (3) make recommendations to governments based on evidence generated. METHODS: Data were collected from clinical record reviews, provider and client interviews, observations, and focus group discussions. Either random or universal sampling was applied in the selection of health facilities assessed. Local nurses and midwives participated in the data collection and, to some extent, data processing and analysis. RESULTS: The coverage of basic EmOC services ranged 0-1.1/500,000 population compared to the UN-recommended level of 4/500,000. The coverage of comprehensive EmOC services ranged 0.5-4.3/500,000 compared to the recommended level of 1/500,000. Between 0.6% and 8.8% of all births took place in EmOC facilities, and 2.1% and 18.5% of all expected direct obstetric complications were treated. Cesarean section as a proportion of all births was between 0.1% and 1%. Shortage of trained staff especially mid-level providers, poor basic infrastructure such as lack of electricity and water supplies, inadequate supply of drugs and essential equipment, poor working conditions and staff morale, lack of communication and referral facilities, cost of treatment, and lack of accountability and proper management were identified as the main obstacles in providing 24-h quality EmOC services especially in remote and rural areas. CONCLUSIONS: Lack of basic EmOC services limits women's access to life-saving services during obstetric complications. To reduce maternal mortality ratio the states and development partners need to focus their effort to improve the coverage, quality, and utilization of EmOC services through supportive national policy, effective program strategies, increased budget allocation to maternal health program, rural infrastructure development, and regular monitoring, and evaluation of progress.

Attitude to Health↗
PubMed1992

Gender-planned health services.

Gender-planned health services are planned on the basis that women and men play different roles in society and have different medical needs. The feminist movement has provided a broad charter of rights for women, reflecting women's needs, but these have yet to be translated into operational programmes. National programmes for women would allow co-ordination of broad-based programmes to improve women's health and social position. To change social norms discriminating against women will require changing male attitudes. Health programmes for males have received little attention, except from family planning organizations, although in most countries, males have a high rate of accidents, infections and parasitic disease. Controlled studies are required to evaluate the benefits of gender-planned health services.

Developing Countries↗
PubMed1991

Training primary health care workers to foster community participation.

A low level of community participation was identified as one of the weaknesses of the health sector in the United Republic of Tanzania. In order to remedy this situation, a systematic process of training trainers and students was established with full involvement of village people. Twenty-five themes were put forward as starting points for discussions between students and villagers. The students were encouraged to learn from the villagers by listening to them and asking them questions. They also participated in community activities and lived with villagers so as to obtain a good understanding of rural living conditions. In this way, problems were identified and solutions were jointly formulated. A workbook was developed during a series of workshops with students, trainers, village communities, and planners. At least two teachers were trained from each health training school; all schools were supplied with workbooks. The approach has been adopted by most health training schools in Tanzania, and the Ministry of Health is now committed to it. Both students and trainers find this to be a valuable learning experience.

Community Health Services↗