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The development of community water supplies in Ghana.

Ghana, with a population of 6 700 000, largely distributed in rural districts, is representative of many a country where the problem of water supply is associated with the construction of numerous small supplies for the villages and towns scattered over the whole area. This paper gives a general impression of the various methods in use for tackling the problem. Well-sinking, drilling, and pond-digging, and the advantages and disadvantages of a variety of methods, are described, and the problems met with under different geological conditions are considered. Details of the various systems for pumping the water from the source to the villages and towns are given. The important question of standardization, both in design and equipment, is dealt with, and reference is made to the operation of supplies and to the training of operatives.

Environment↗

Developing community-based services for youth with disabilities.

Five community-based services in Israel for disabled adolescents are described. Three of them are day centers and two are afternoon clubs. They provide rehabilitation resources for teenagers with various kinds of disabilities including cerebral palsy, mental retardation, blindness, deafness and emotional handicaps. These services are analyzed and discussed with regard to addressing the major needs of adolescents with disabilities, with the aim of achieving an optimal degree of independence and preparation for normalized life. The programs include resources such as vocational rehabilitation, independent living education, recreational activities, social skills training, sexuality education in addition to creating opportunities to mix and socialize with nondisabled youth. The function of pediatric and adolescent medicine physicians in such services is emphasized as imperative in providing a comprehensive rehabilitation program for youth with disabilities.

Adolescent↗

Politics, public policy, and the development of community mental retardation services in the United States.

Data emanating from the community services component of the Third National Study of Public Spending for Mental Retardation and Developmental Disabilities was analyzed. An empirical model of community services spending in the states was tested in a hierarchical regression analysis using cumulative community services fiscal effort in the states across 1977-1988 as the dependent variable. Strength of consumer advocacy organizations in the states coupled with states' historical orientations toward the adoption of policies promoting racial equality were highly significant predictors of state-by-state variance in community spending patterns. The implications of this and other findings emerging from the national study were discussed.

Community Mental Health Services↗

Rationale for a program in community ophthalmology.

The high incidence of eye abnormalities among blacks, coupled with the relative unavailability of ophthalmic services, has resulted in excessive rates of blindness otherwise preventable or curable. As a consequence, incidence rates for blindness are higher for the black population than the white population.Statistics show that black children requiring eyeglasses are less likely to receive eyeglasses than similar age-matched white children. In virtually every state surveyed, blacks were more frequently and severely afflicted with eye diseases and were less likely to receive treatment than whites. Yet, no programs exist in any state specifically targeted to promote eye care among blacks and reverse the ever-worsening trend. Additional data characterizing the scope of the problem shall be presented.An initial strategy for approaching the problem, namely, community ophthalmology, has been developed. Community ophthalmology represents a new discipline promoting eye health and blindness prevention through programs utilizing methodologies of public health, community medicine, and ophthalmology. Basically, the use of community ophthalmology strategies is critical to positive out-come, when given a population composed of blacks and other minorities who are chronically underserved with regard to all sectors of health.The evolution and rationale for these concepts are discussed from national, as well as international, perspectives.

Adolescent↗