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[Evaluation indicators of the Healthy Municipalities for Peace strategy in Colombia].

OBJECTIVES: The work that is presented is the first phase of a scale development study. The objectives are: selecting, developing and evaluating indicators for the evaluation of the healthy cities project in Colombia, in order to offer the bases for the construction of a measurement scale. METHODS: The project was executed from January 2001 to August 2002. A validation by construct and an assessment of indicators, according to their importance, data availability and formulation were carried out. A theoretical heuristic model for evaluating the Colombian Healthy Cities Project was developed; based on these model 128 indicators were defined. A preliminary instrument was then made and evaluated by experts in the strategy. A test was carried out in five cities in order to test data availability and formulation. RESULTS: The final results are a heuristic model for the evaluation of the project and an evaluation of each indicator. CONCLUSIONS: The final results are not finished. A greater effort is needed for developing good heuristic models and for building instruments for assessing the healthy cities project in Colombia.

Colombia↗
PubMed2003

[Lalonde's paradigm, World Health Organization and new public health].

The authors present the origins and evolution of the New Public Health idea assuming the fundamental significance of Lalonde's health field concept in this process. The other crucial events which contributed to it was the formulation and implementation of WHO strategy HFA 2000, publication of Ottawa Charter, defining by WHO the essential public health functions and concepts of Gro Harlem Bruntland from 1998-1999 when she was the Director General of WHO. Authors present for discussion their working definition of New Public Health, which is based of the public health definition of J. Nosko et al. from 2001.

Global Health↗
PubMed2002

Communication in health care delivery in developing countries: which way out?

Most governments in developing countries have adopted frameworks for health development which stressed community based initiatives and intervention at all levels of the health pyramid (WHO, 1992). But even today, most of the rural communities in these countries are still not developed in terms of available health facilities. What then is/are responsible for these failures? Various authors have come up with various reasons, principal amongst which are inadequate resources, lack of planning, insincerity/non-commitment of the governments, lack of modern information technology, etc. This paper examines some of these factors in relation to how they accentuate or hamper healthcare delivery in developing countries, using African rural communities as a study field. The resultant suggestions are a consortium of varying factors, some of which are economic in nature, policy changes, human resources development, and re-orientation of social and government attitudes towards achieving meaningful results in healthcare delivery, particularly in the rural communities.

Africa↗
PubMed2003

From risky behaviors to chronic outcomes: current status and Healthy People 2010 goals for American Indians in Oklahoma.

OBJECTIVES: The objective was to estimate the rates of behavior-related risk factors among American Indians in Oklahoma, and compare those to the Oklahoma general population rates and Healthy People 2010 goals where available. METHODS: The REACH 2010 Native American Behavioral Risk Factor Survey, a random telephone survey, was conducted in 2000 as a part of the larger national REACH initiative. It had 3,732 respondents and it included measures related to health status, health care access, overweight, exercise, tobacco use, alcohol use, hypertension, cholesterol screening and diabetes. RESULTS: Self-reported health status was excellent or very good among 52% of respondents and fair or poor among 21%. Sixty-one percent of adults were overweight or obese. Prevalence of current cigarette smoking was at 33%. Binge drinking in the last month was present among 18% of American Indian adults. Thirty percent of adults did not engage in any leisure time physical activity during the last month. Diagnosed high blood pressure was reported by 26% of respondents, and prevalence of diabetes exceeded 8%. CONCLUSIONS: Majority of the recorded behaviors are above Healthy People 2010 goals, and exceed Oklahoma general population rates. There are also some significant gender differences, demonstrating the need for targeted intervention activities.

Adult↗
PubMed2004

Influenza vaccination of persons with cardiovascular disease in the United States.

People who have cardiovascular disease are at increased risk of hospitalization or death associated with influenza infection, and are included among the high-risk groups for whom annual influenza vaccination is recommended. To measure the progress toward the national year 2000 and 2010 objectives of a 60% annual influenza vaccination of adults with high-risk conditions aged 18 to 64 years, we analyzed data from the 1997 to 2001 National Health Interview Surveys (NHIS) regarding persons with cardiovascular disease. The NHIS is an annual, cross-sectional survey representative of the U.S., noninstitutionalized, civilian population. Estimated percentages of persons with heart disease reporting influenza vaccination were relatively stable during the 1996-97 through 2000-2001 influenza seasons, with the highest levels in most groups occurring in 1999-2000: 49.2% (95% confidence interval [CI], 44.1%-54.3%) among persons aged 50 to 64 years; and 22.7% (95% CI, 18.2%-27.2%) among persons aged 18 to 49 years. Influenza vaccine coverage among adults aged 18 to 64 years with cardiovascular disease is substantially below the national objective. Multiple strategies are needed to improve vaccination coverage, such as increasing the awareness of and demand for vaccination by persons with heart disease; increasing implementation by providers of practices that have been shown to increase vaccination levels; and adopting of influenza vaccination by primary care providers and specialists as a standard of care for persons diagnosed with cardiovascular disease.

Adolescent↗
PubMed2004

Health-related millennium development goals: policy challenges for Pakistan.

OBJECTIVES: There are two objectives: (a) to clearly articulate the Millennium Development Goals (MDGs) adopted by the United Nations in 2000 and their implications for developing countries like Pakistan; and (b) to critically review the challenges faced by Pakistan in achieving the health-related MDGs. METHODS: A critical review of secondary data and information generated primarily by multilateral agencies and United Nations organizations. RESULTS: The MDGs represent a global consensus on the broad goals of development to be achieved by 2015. Of the eight Millennium Development Goals, three are specifically health related--reducing infant (under-5) and maternal mortality; and combating HIV/AIDS, tuberculosis, malaria and other significant communicable diseases. According to various studies, many developing countries will not achieve the MDGs without concerted efforts and commitment of additional resources. Like many other developing countries, Pakistan is also faced with an enormous challenge in reaching the Millennium Development Goals and targets set by the United Nations. For Pakistan, perhaps the most challenging MDG is that of reducing "by three-quarters the maternal mortality ratio." Maternal mortality is so intertwined with other "social" factors--including the status of women--that a comprehensive holistic approach is required. CONCLUSION: In order to achieve the MDGs, Pakistan would require a fundamental shift in its policy and strategic directions. Along with allocation of significant additional resources for health, it needs to review and reprioritize the use of existing resources, focusing more on primary health care. Pakistan must also adopt a holistic integrated approach that views health, education, and other social sector development as intrinsically interrelated and interwoven. Without such an integrated approach, achieving the health-related MDGs is likely to remain illusive for Pakistan. There is a critical need to foster a healthy debate on the health-related Millennium Development Goals in Pakistan so as to inform and, hopefully influence, public policy.

Developing Countries↗
PubMed2004

[European action plan on alcohol in the Czech Republic--no substantial progress].

Czech Republic joined European action plan on alcohol for years 2000 to 2004 and signed its accomplishment. However, since 2000 situation has worsened. Alcohol consumption raised in 2001 (the last known data) to 10.0 litters of 100% alcohol (that is 159.9 litters of beer, 8.2 litters of distillates and 16.2 litters of wine per person per year). The only positive aspect was the small rise of consumption tax in distillates and that some thesis of the European action plan on alcohol were included into the governmental document "Long-term improvement of the health status of the population in Czech republic--Health for everybody in the 21st century". The proclamation has had no practical effect. Highly adverse is the situation with alcohol consumption in children and adolescents, which was described in the last study. Risks related to the high alcohol consumption in Czech republic include: High incidence of alcohol related death, including children, adolescents and young people (injuries, traffic accidents, poisonings, suicides, liver and tumor diseases); higher morbidity; lower productivity at work and worse position of Czech workers in concurrent environment; worse reproduction health, higher incidence of inborn defects caused by alcohol taken during pregnancy (including its beginning, when women do not know it); frequent social and family problems caused by alcohol abuses; increased risk of consumption of non-alcoholic drugs in children and adolescents. Alcohol belong to throughway drugs and its consumption in early age represents for children and adolescents a risk factor for other addictive drugs; alcohol is related namely to violent and negligent delicts; flagrant alcohol excesses together with alcohol related criminality harm the prestige of Czech Republic to foreign visitors and can drive them back.

Alcohol Drinking↗