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PubMedDate not supplied

The control of measles in tropical Africa: a review of past and present efforts.

Measles in tropical Africa is endemic and cyclical, with a high incidence that usually peaks during the dry seasons. Measles may be a contributing factor in 10% of all deaths among African children. Several problems have hindered measles immunization programs in Africa; these include difficulties in maintaining the cold chain, poor epidemiologic surveillance, and the logistical problems involved in reaching a population that is 80% rural. The United States Agency for International Development and the World Health Organization both have programs that are helping to increase immunization coverage and to solve the problems just mentioned. Many countries have begun to train their own personnel to administer immunization programs. However, because of limited staff and equipment, a high birth rate, and an uncertain social situation, no firm predictions can be made concerning the permanent control of measles in tropical Africa.

Africa↗
PubMed1987

Primary health care is not cheap: a case study from Guinea Bissau.

In 1977 the Ministry of Health in Guinea Bissau started two regional community health projects. In this article we describe the progress of the Tombali project. Three aspects are discussed: the "Learning Process Approach" used in the project; measurement of the effectiveness of the project and the problems of collecting and interpreting these data; and the ratio of investment to recurrent costs and the proportions borne by government and by villagers. Primary health care projects evolve slowly, and the importance of the willingness of project workers, donor agencies, and the national government to work without a blueprint plan is emphasized. We discuss ways of evaluating the success of primary health care schemes; the measurement of any change in health status is difficult and discounts other benefits that may result, such as encouraging community participation and involving villagers in government activities. Both government and villagers contribute significantly to the scheme, the government and donors bearing most of the investment costs, while most of the recurrent costs fall on the villagers. The data show that for neither government nor villagers is the scheme a cheap option to secure health care for rural populations. Finally, we discuss the lessons to be learned by national governments, donor agencies, and health workers from this attempt to implement a primary health care program.

Budgets↗
PubMed1996

Focus on women in Cambodia.

Dr. Mam Bunheng, Undersecretary of State for Health, Cambodia, provided an overview of the health situation of women and children in Cambodia during a visit to JOICFP on December 8. He also expressed his country's desire to seek collaboration with JOICFP in the future. Providing background on the maternal and child health (MCH) system in Cambodia, Mam explained that the birth-spacing program is an integral part of the MCH activities and is primarily aimed at ensuring the health of women. Cambodia, which has a population of about 10 million people, presently has a high maternal mortality rate of 500/100,000 deliveries. Noting that the country also has a high total fertility rate of about 5.1, Mam emphasized that the government's birth spacing program is not aimed at controlling the population, but rather to ensure balanced development and population growth with the ultimate goal of guaranteeing the health of women. Cambodia also has a high infant mortality rate of 113/1000 live births. Mam explained that lack of access to services, supplies, and trained personnel hamper efforts to promote birth spacing. To overcome these obstacles, Cambodia needs support to develop human resources and to ensure supplies of basic medical equipment and essential drugs. Specifically, Mam stressed the need to train and retrain health staff to ensure adequate staffing at the community level. At present, the total number is insufficient, he said. While in Japan, Mam visited many health facilities as part of JICA's technical cooperation program and was impressed most with the quality services and facilities of the public health center.

Asia↗
PubMed2000

Development of notification policy in Namibia.

On 21 April, 1999, the Namibian press reported that the government was going to declare AIDS a notifiable disease. This announcement sparked much debate about the role of confidentiality in a sound public health approach to the prevention and control of HIV/AIDS. It also became apparent that in Namibia people's understanding of the principle of confidentiality varies widely. Many seem to confuse the concepts of secrecy and confidentiality. They see preserving confidentiality about HIV/AIDS information as strengthening the "veil of secrecy" that surrounds HIV, reinforcing stigma and undermining efforts to control the spread of HIV. A consultative process, initiated by Joint UN Program on HIV/AIDS, led to the formulation of a much needed policy framework for reporting and notification of HIV/AIDS. A task force was established to identify, discuss and report on national issues, policies and experiences that could inform the discussion on HIV reporting and confidentiality.

Acquired Immunodeficiency Syndrome↗