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Biomedical subjects

W H Mosley

Publications and source records attributed to W H Mosley.

At least 19 recordsLinked to original sources
PubMed1994

Population change, health planning and human resource development in the health sector.

As a result of the demographic and epidemiological transitions now occurring rapidly in many developed countries, a dramatic shift in the age structures of populations and the burden of disease towards the middle-aged and elderly is expected to take place over the next several decades. In the 1990s, however, there remains great diversity across countries in fertility levels and mortality patterns. The World Bank's 1993 World Development Report assessed the global burden of disease in order to define the minimum packages of public health measures and clinical interventions that would improve health conditions in low-income countries in a cost-effective and affordable way. Strategically implementing these programmes will require that government investments be directed toward a limited number of cost-effective health interventions, delivered equitably to the entire population. At the same time, steps must be taken to improve the efficiency and contain the costs of health care delivery in the public and private sectors. Such a population-based health strategy will require the development of a wide range of scientific, analytical and technical capacities, currently rare in most ministries of health. This will require the involvement of epidemiologists, demographers, sociologists, analysts, operations research specialists and environmental health scientists. Building up these capabilities in health ministries, universities or the private sector will be an essential ingredient of health system reform.

Adolescent↗
PubMed1991

Disease control priorities in developing countries: health policy responses to epidemiological change.

Health systems in developing countries are facing major challenges in the 1990s and beyond because of a growing epidemiological diversity as a consequence of rapid economic development and declining fertility. The infectious and parasitic diseases of childhood must remain a priority at the same time the chronic diseases among adults are emerging as a serious problem. Health policymakers must engage in undertaking an epidemiological and economic analysis of the major disease problems, evaluating the cost-effectiveness of alternative intervention strategies; designing health care delivery systems; and, choosing what governments can do through persuasion, taxation, regulation, and provision of services. The World Bank has commissioned studies of over two dozen diseases in developing countries which have confirmed the priority of child survival interventions and revealed that interventions for many neglected and emerging adult health problems have comparable cost-effectiveness. Most developing countries lack information about most major diseases among adults, reflecting lack of national capacities in epidemiological and economic analyses, health technology assessment, and environmental monitoring and control. There is a critical need for national and international investment in capacity building and essential national health research to build the base for health policies.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The Saradidi, Kenya, rural health development programme: retrospective demographic analysis.

A census was done in Saradidi, Kenya from 1980 to 1982 as part of a community-based health development programme. The population was 42,755 (excluding 39 persons of unknown age or sex); 17.1% were less than five years old, 46.9% were below age 15, 4.7% were age 65 years or older and 19.7% were women in the reproductive years (age 15 to 44 years). The sex ratio was 86 males per 100 females due principally to migration of adult males for work. The mean number of persons per household was 4.0 and the mean village population was 764. The singulate mean age of marriage for men was 27.0 years and for women 19.9 years; 0.8% of adult men had never married. Only 0.1% of women by age 50 had never been married. Men were significantly more likely than women to be married to more than one spouse, divorce and separation was higher among men, and by age 50 about one-third of women were widows. Men had more years of formal education than women and young people of both sexes more than older people; 73.1% of men and 96.1% of women 60 years and more had never attended school. Infant mortality rates estimated indirectly ranged between 139 and 155 by area. A strong association was found between increasing education of the mother and decreased reported mortality of children. The total fertility of 6.2 was high but lower than the national average possibly because of the high rates of polygamy and primary infertility and the long periods of amenorrhoea and breast feeding which occurred after delivery. This area continues to have one of the highest levels of infant and child mortality in Kenya as well as relatively high fertility and a population with a very young age structure. This implies a continued very rapid rate of population growth which will make more difficult in the future the problems of delivering effective health services and overcoming poverty. A vigorous programme directed toward improving health is indicated which must include family planning.

Community Health Services↗
PubMed1987

Impact on mortality and fertility of a community-based malaria control programme in Saradidi, Kenya.

Mortality and fertility rates were measured from 1981 to 1983 by prospective registration of vital events as part of a community-based malaria control and health development programme in Saradidi, Kenya. There was no obvious effect of providing chloroquine phosphate for treatment of malaria in each village on mortality or fertility rates. Crude death rates were 13.1 in the year before intervention (1 May 1981 to 30 April 1982) and 12.3 after intervention (1 September 1982 to 31 August 1983). Neonatal mortality increased from 36.8 per 1000 live births pre-intervention to 49.1 during intervention. There was a slight decline in post-neonatal (one to 12 months) mortality (72.8 to 67.0) and a significant drop in early childhood mortality (25.2 to 18.2). The change in mortality rates in these two age groups were fully explained by a high rate of measles mortality in the pre-intervention period. Measles accounted for 35.7% of 284 reported deaths in infants one to 12 months of age and for 40.9% of 230 deaths in children one to four years old. There was little change in reported malaria-specific mortality rates in infants and young children most likely because of a high level of chloroquine use for treatment of presumptive illness. Perinatal mortality by area ranged between 60.4 and 81.3 pre-intervention to 79.5 to 97.2 after the control programme was instituted. Crude birth rates by area remained stable at about 40 and general fertility rates were about 200. Both pre-intervention and during intervention infants were significantly more likely to have died without medical consultation than children one to four years. However, 79.2% of 284 infants and 90.7% of 193 children died in spite of having consulted a health worker prior to death. The data suggest that a measles vaccine programme would significantly reduce mortality rates in infants and young children. The fact that the majority of infants and young children died in spite of receiving medical attention indicates both the inadequacy of curative medical services in this high mortality setting as well as the necessity for promoting preventive health measures.

Adolescent↗
PubMed1981

The relationship of cholera to water source and use in rural Bangladesh.

The cholera experience of a sample of families in a rural area of Bangladesh is reported in relation to water supply and use. Tanks were the primary source for 65% of families, canals for 20% and the river for 14%. The highest attack rate was associated with access to canal water (13%). Attack rates did not vary markedly according to the purpose for which a source was used. The importance of cultural patterns in water use is identified.

Bangladesh↗
PubMed1978

Postpartum amenorrhea: how is it affected by maternal nutritional status?

The average length of postpartum amenorrhea reported by breast-feeding women in rural Bangladesh in 1975 was 18 to 20 months. Its duration was found to be only slightly related to maternal nutritional status. There was no evidence of a threshold of weight for height necessary for the resumption of menses postpartum. Factors related to the duration of postpartum amenorrhea were maternal age, socioeconomic status, and supplemental feeding of the infant.

Amenorrhea↗
PubMed1976

The effectiveness of family planning education on acceptance of contraception by postpartum mothers.

A prospective controlled study on the maternity service of the American University Medical Center, Beirut, Lebanon, tested the effect of family planning education during the postpartum lying-in period on recruiting contraceptive acceptors. The study further determined how women with different socio-demographic backgrounds, life styles, and levels of readiness for the practice of family planning responded to the educational program. The results revealed that a postpartum educational effort could almost double family planning acceptance among women who returned to the postpartum clinic within the first 9 weeks after delivery and that the educational impact was evident irrespective of the respondents' socio-demographic characteristics, life styles, and levels of readiness for family planning.

Adult↗