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At least 469 records · Page 26Linked to original sources
PubMed1984

Project community diagnosis: participatory research as a first step toward community involvement in primary health care.

'Community participation' and 'bottom up planning' have become fashionable themes in international health circles. However, in the absence of sociocultural perspective these themes remain largely rhetoric. In this paper, a deprofessionalization of social science is advocated in the service of participatory research as a first step towards community involvement in primary health care. Deprofessionalization is suggested as an adjunct to, not a replacement for in-depth professional social science research. An exploratory community diagnosis of health project conducted in rural south India is described. During the project, lay researchers received rudimentary social science field training and collected data on health behaviour deemed important to health planners as well as the health concerns of the community. Illustrative data, generated by the project is presented on the rural poors' utilization of government health facilities, their attitudes towards Primary Health Centre staff, and their ideas about how a proposed community health worker scheme could best serve them.

Community Health Workers↗
PubMed2000

Agricultural science and food policy for consumers and workers: recipes for public health successes or disasters?

In the world of high speed globalization, the search for global food and water security has failed despite being driven by aggressive agribusiness and aided all too often by so-called Green Revolution research scientists and technologists. In the process, agricultural workers, rural communities, and food production workers face significant occupational and environmental hazards. Countervailing forces to the World Trade Organization (WTO) and agribusiness food strategies are needed. Critical to these forces will be Non-Governmental Organizations (NGOs) working toward non-toxic, nondestructive, community-based agriculture informed by integrated humanistic, scientifically cautious, worker-sensitive, and ecologically located principles.

Journal Article↗
PubMed2002

Revealing a hidden problem. An evaluation of a community dementia case-finding program from the Indian 10/66 dementia research network.

BACKGROUND: Dementia in India is largely a hidden problem with no community awareness and little help seeking from affected families, despite high levels of strain. Cases must therefore be identified before practical help can be offered. METHOD: After two and a half hours of formal training, local community health workers in rural Kerala were asked to identify possible cases of dementia from the community they served. Diagnoses were then verified by a senior local psychiatrist with clinical and research interests in old age psychiatry. RESULTS: The community health workers identified 51 out of 1979 over 60 year old residents (a prevalence of 2.6%) as suspected cases of dementia. Following the psychiatrist's assessment, 33 met DSM-IV criteria for dementia. The majority of confirmed cases were of the Alzheimer's Disease sub-type. Most "non-cases" were found to be suffering from other major psychiatric disorders, with substantial unmet need. The positive predictive value of the community health workers informal screening was 64.7%. CONCLUSIONS: This simple cost-effective case-finding method can be of practical use in the development of community based dementia care services in India and other developing countries with similar health care systems.

Aged↗
PubMedDate not supplied

Integration of yaws control and primary health care.

Where a primary health care (PHC) system (e.g., a community health worker and a health center as the first referral level) is fully operational, control activities for yaws should be part of PHC. Where the whole population is adequately covered, the PHC system is responsible for early detection of cases of active clinical yaws, treatment and follow-up of these cases, treatment and follow-up of contacts, and health education related to yaws control. In circumstances where PHC is not as yet fully implemented, the structure for a yaws control program must be different. In areas with adequately functioning static health services or with a nascent PHC system, yaws control could be started as a vertical program--initial treatment survey and resurvey by a yaws team working in close collaboration with a health worker selected by the community. Subsequently, active yaws surveillance is taken over by that worker who also assumes the other functions of primary health care. In areas with nonexisting or poorly functioning static health services, a program for yaws control should not be implemented because control and effectiveness are likely to be poor.

Adolescent↗
PubMed2005

Building on leadership and social capital to create change in 2 urban communities.

There has been an appeal to reduce health inequities by increasing community involvement and social capital. Poder es Salud/Power for Health is a community-based participatory prevention research project that seeks to address health disparities in the African American and Latino communities by enhancing community-level social capital. We provide specific examples of how this intervention uses community health workers and popular education to reduce language and cultural barriers and enhance community social capital. Although the communities share fundamental challenges related to health disparities, the ways in which the Latino and African American communities identify health concerns, create solutions, and think about social capital vary. Members of the project are working together to identify opportunities for cross-cultural collaboration.

Black or African American↗
PubMed2005

The use of community-based animal health workers to strengthen disease surveillance systems in Tanzania.

An 18 month trial was conducted in three districts of Arusha region, northern Tanzania, to assess the use of community-based animal health workers (CAHWs) in an official disease surveillance system. Disease reports provided by CAHWs were assessed using six indicators for effective disease surveillance, i.e. sensitivity, specificity, timeliness, representativeness, simplicity and acceptability. To assess sustainability issues and determine the incentives required by CAHWs to report disease, three different incentive models were tested in the trial. None of the incentive models involved direct payments to CAHWs. Before involving CAHWs in disease surveillance in the three trial districts, disease case reports as a proportion of cattle population were 0.13%, 0.20% and 0.12%. During the trial, disease case reports as a proportion of cattle population increased to 5.0%, 5.6% and 6.3%. The CAHWs also improved the spatial and temporal coverage of the disease surveillance system and provided timely reports. During the trial, national-level disease reporting in Tanzania increased by 17% owing to the sensitisation and support activities of the Pan African Programme for the Control of Epizootics in Tanzania. In Arusha region, disease reporting increased by 118%, and 49% of this improvement was attributable to increased reporting in the three trial districts. Reporting from these districts far exceeded that from any other district in Tanzania. Veterinarians confirmed the CAHWs' clinical diagnosis in 88% of the 170 clinical cases examined. The increase in disease reporting resulting from CAHW activities was sufficient to enable the national epidemiology unit to achieve its target in relation to World Organisation for Animal Health (OIE) guidelines. The authors conclude that the use of CAHWs should be promoted in the national strategy for disease reporting. Additionally, CAHWs must be brought under the control of the Tanzanian veterinary authorities, a process that will include appropriate legislative reform.

Animal Technicians↗
PubMed1984

The geriatric worker in a community-based out-patient geropsychiatry clinic: a conceptual model.

This paper describes the role of the geriatric worker as a member of the service provider team in a community-based geropsychiatry out-patient program using the bio-psycho-social model. Three major components are identified: the functional role, the affective role, and the community-integrative role. The contribution of the worker is shown to be significant in the attainment of the goal of outpatient geropsychiatry: that being the resocialization and maintenance of the elderly person with special needs in the community.

Aged↗
PubMed1990

Community health care and hospital attendance: a case study in rural Ghana.

This study assesses the influence of coverage with a network of PHC clinics as well as private clinics in Dormaa District, Ghana on, hospital attendance. This influence is measured by analysing hospital attendance among inhabitants during 6 months in 1984 and 1986. Several conditioning factors are analysed: the type of modern health care present in the community and the experience of the community health worker (CHW); the distance between community and hospital; the time factor (1984 and 1986); the sex and age of the attendants; the diagnosis made at the hospital. It appears that fewer people attend the hospital if a community participates in the PHC programme and if the CHW is experienced. When people from these communities attend the hospital they do so less unnecessarily than those from other communities. Simple analysis of routine hospital data may contribute to any PHC assessment programme set up around the hospital.

Community Health Services↗
PubMed2004

Primary health care in practice: is it effective?

Primary health care is accepted as the model for delivering basic health care to low income populations in developing countries. Using El Salvador as a case study, the paper draws on three data sets and a qualitative survey to assess health care access and utilization across public and private sector options (including NGOs). Multivariate analysis is used to estimate the quantitative determinants of health seeking behavior. Physical and financial access is generally good. Households do not value the community health workers, and prefer high cost private care, even the poorest families, because of the lower waiting times and higher probability of successful treatment. Similarly, higher level public facilities--health centers and hospitals--are preferred because they are less costly in terms of time as they offer "one stop shopping" and do not require multiple visits, and treatment success is higher than among health posts, health units or community health workers. These results combined with the small size of El Salvador suggest that alternative strategies to community health workers may be a more cost effective approach. While prevention is desirable, community health workers do not have the skills or services that the communities value, which makes them less effective in promoting prevention. Alternative modes of reaching the community could reduce costs and raise the effectiveness of public health spending.

Adolescent↗
PubMed1983

Family planning field research projects: balancing internal against external validity.

This report discusses the experience of a two-year family planning and maternal/child health project in Nepal. Although the project was planned as an experimental field research endeavor, a series of unanticipated events repeatedly compromised the internal validity of the project and forced design changes. While unexpected events are common in the history of most field projects, they present the research evaluator with the fundamental dilemma of trying to maintain a high degree of internal validity without sacrificing external validity. Rigid research designs with tight control over the introduction and measurement of experimental variables may serve to increase internal validity but they may also create an atypical and artificial situation that fails to mirror real field conditions and thus threatens external validity.

Community Health Services↗
PubMed1982

Evaluation of a community-based system for training natural helpers. II. Effects on informal helping activities.

A set of 37 rural "natural helpers" chose to become involved in a community-based program of training to enhance their helping skills. Data were collected on the following dimensions of the helpers' informal helping activities: number of helping interactions, different persons helped, relationship to helpee, length of helping contact, location, types of helpee problems, kinds of helping behaviors used, and helper-perceived confidence, helpfulness, and satisfaction. Comparison of helpers' reports on these dimensions prior to and after training showed these changes: (a) a greater proportion of interaction with spouses, (b) more interaction in helpees' homes, and (c) more confidence in helping. Comparisons of changes between helpers who acquired specific helping skills and those who did not gave indeterminant results. Helpers' reports of their community behaviors were not congruent with direct observations of their behavior in evaluation sessions.

Community Health Workers↗
PubMed1977

The interfacing of constituencies.

Within a public human service organization interaction occurs among diverse constituencies such as clients, donors, and professionals. Several recent trends affecting relationships among constituencies are identified and problems emerging from these trends are considered. Since various changes within human service organizations have occurred during the 1960s and early to mid-1970s, one may speculate about future developments which may result from these trends. It is suggested that each constituency must adapt to changing circumstances in a spirit of cooperation if the organization is to be effective.

Attitude of Health Personnel↗