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Biomedical subjects

W R Brieger

Publications and source records attributed to W R Brieger.

9 recordsLinked to original sources
PubMed1992

Primary care training for patent medicine vendors in rural Nigeria.

The provision of essential drugs and the involvement of various potential and existing health care providers (e.g. teachers and traditional healers) are two important primary health care strategies. One local group that is already actively supplying the medication needs of the community is the patent medicine vendors (PMVs), but the formal health establishment often views their activities with alarm. One way to improve the quality of the PMVs' contribution to primary care is through training, since no formal course is required of them before they are issued a license by government. Primary care training was offered to the 49 members of the Patent Medicine Sellers Association of Igbo-Ora, a small town in western Nigeria. Baseline information was gathered through interview, observation and pre-test. A training committee of Association members helped prioritize training needs and manage training logistics. Thirty-seven members and their apprentices underwent the 8 weekly 2-hr sessions on recognition and treatment (including non-drug therapies) for malaria, diarrhoea, guinea worm, sexually transmitted diseases, respiratory infections, and malnutrition, plus sessions on reading doctor's prescriptions and medication counseling. The group scored significantly higher at post-test and also showed significant gains over a control group of PMVs from another town in the district. The Igbo-Ora experience shows that PMVs can improve their health care knowledge and thus increase their potential value as primary health care team members.

Adult↗
PubMed1991

Guineaworm control case study: planning a multi-strategy approach.

The planned global eradication of guineaworm (dracunculiasis) offers opportunities to learn about relatively complicated disease control situations. Unlike smallpox, which was eradicated over 10 years ago through immunization, the guineaworm problem has no one solution, but must rely on a variety of technologies to protect, treat or replace existing unsafe community water supplies which harbour the disease. Experiences in rural Nigeria have shown that a multi-strategy approach is necessary to account for differences in geographical settlement patterns, local culture and beliefs, geology of the area, economy of the villages and political clout of town leaders among the five major segments of the community. Through a self-help primary health care programme, residents of the Idere community were able to dig wells, produce and distribute cloth water filters bringing a reduction in disease incidence in some areas. It was also seen that generally low standards of living exacerbated by scattered outlying settlements made self-help difficult. Unfortunately occasional government and private efforts did not succeed because of a lack of community participation. Programme planners must involve the consumers in diagnosing these community characteristics and in planning, supervising and maintaining the resulting projects. The multi-strategy approach will help avoid wasted resources and false expectations that arise when project staff attempt to apply a "magic bullet" solution to a complex problem.

Case-Control Studies↗
PubMed1990

Farmers' loss due to Guinea worm disease: a pilot study.

Guinea worm disease has been blamed for much disability and loss of productivity among farmers in Africa and South Asia. Many studies have tried to equate days lost in illness to monetary values. These attempts often overlook the process of disability in relation to farming patterns. This pilot effort uses a qualitative case study approach to learn about how Guinea worm can cause loss to farmers. Twenty in-depth interviews with affected farmers showed that their losses are related to the time of year they are affected by Guinea worm. Some crops with flexible planting times, e.g. cassava, may not be as affected. Duration of disability is another determining factor. Insights from this pilot study can be used to design more appropriate large-scale survey instruments and guide development of longitudinal research.

Agricultural Workers' Diseases↗
PubMed1989

Guinea worm: an in-depth study of what happens to mothers, families and communities.

This paper reports on the impact of maternal morbidity due to guinea worm, dracunculiasis, on the care and health of children under 24 months old, and the way in which the mothers and the family coped with the often extended periods of disability. This qualitative study is based on observation and in-depth interviewing, supplemented by focus group discussions. Of 42 mothers with guinea worm in two hyperendemic areas of Oyo and Kwara States, 28 were either bedridden or only able to hobble short distances with the help of a stick; the average period of incapacity was almost 9 weeks. Of the four maternal roles identified (child care, self care, domestic tasks, income generation), the women gave priority to child care; 34 of the 42 mothers needed help in child care. Coping networks operated principally within the extended family, but also included women in other households, and women from beyond the community. Thus the impact of a mother's illness extended beyond her children and family to the wider community. This qualitative study thus reveals the multifaceted impact of a disease on individuals and on the community. The study stresses the need for, and availability of, effective methods for controlling guinea worm by utilizing community cooperation to provide protected water sources and other preventive measures against the disease.

Activities of Daily Living↗
PubMed1978

Developing service-based teaching in health education for medical students.

In the expanding concern about the social-behavioral aspects of health care in medical education, health education has opportunities for making itself an important part of basic medical training. The need is to actually define a physician's appropriate educational tasks and competencies as a basis for curriculum development in health education which would ideally be integrated into the whole educational program. This case study presents efforts to develop an educational service component at a rural health center which, connected to a major teaching hospital, serves as a learning base for medical students. Through trial and student feedback a program has been developed which includes patient counseling, evaluative home visits, group education sessions, exit interviews, medication counseling, community needs assessment and educational consultation with local school teachers. With this program as a foundation, the goal is to integrate health education learning throughout the rest of the medical curriculum.

Community Health Centers↗
PubMed1978

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Community Health Services↗