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PubMed1991

Malaria and its control in the People's Republic of China.

Malaria is one of the major parasitic diseases in China. During the past 40 years, large scale malaria control activities were conducted in the country relying on primary health care nets and community participation. The control of malaria was implemented according to the principles of adopting integrated measures and repeated practices which are characterized by time- and locality-oriented approaches. As a result, remarkable success has been achieved. By the end of 1990, there were 117,000 malaria cases in China, with a morbidity of 0.0106%, which dropped by 95% in comparison with that in the 1950s. Most of the original hyper-endemic areas became meso- or hypo-endemic and for most of the previously meso- or hypo-endemic areas, the disease became sporadic. Malaria distribution and epidemic patterns also demonstrated great changes. The major experience comprises the integration of the malaria control program into the overall national health program, the mobilization of various sectors, including the community, the investigators and technical personnel in research institutions and control services to participate and cooperate in solving problems and difficulties encountered.

China↗
PubMed2006

Measuring the cost-effectiveness of a national health communication program in rural Bangladesh.

In this article we examine the cost-effectiveness of the Smiling Sun multichannel media campaign, which was undertaken in Bangladesh from 2001 to 2003 and involved a nationally broadcast television serial drama supported by radio, television, newspaper, and billboard advertisements and local promotion activities. The goal was to encourage the use of a package of family health services at NGO (nongovernmental organization) Service Delivery Program (NSDP) providers. This analysis relates the costs of the Smiling Sun campaign at the national and local level to measures of change in the use of health services, namely, antenatal care and childhood immunizations. Effectiveness is measured using data from cross-sectional surveys conducted in 2001 and 2003 in NSDP catchment areas in rural Bangladesh. The statistical approach, bivariate probit estimation, controls for nonrandom exposure to the program's media messages, advertisements, and signs. Using national-level data, we find that the Smiling Sun campaign was both effective and cost-effective, inducing higher levels of service utilization for only $0.05 per additional antenatal care (ANC) user and only $0.30 and $0.36 for each additional child vaccinated for measles and DPT3, respectively. With respect to local promotion activities, the cost per attributable behavior change was considerably higher--nearly $8 per new ANC user, $37 per new DPT3 vaccination, and $32 per new measles vaccination.

Adolescent↗
PubMed1978

Toward assuring confidentiality of records in large-scale assessment programs.

EPSDT, or any similar national health program, will spawn multiple records on millions of children and adults. Multiple providers will need to share more data to provide quality care. Maintaining privacy of child/parent records, avoiding the dangers of labeling, controlling the life of records and insuring their appropriate demise exacerbate record maintenance problems. Principles of record-keeping confidentiality are proposed.

Attitude of Health Personnel↗
PubMed2006

Programmatic factors related to smallpox vaccine uptake by healthcare workers and others.

We surveyed program coordinators at 106 hospitals and health departments that participated in the National Smallpox Vaccination Program to ascertain how program-level factors affected the rate of smallpox vaccine uptake by staff. In a fully adjusted multivariate model, health departments achieved significantly higher vaccination rates than did hospitals, as did facilities that invited fewer employees to be vaccinated.

Attitude of Health Personnel↗
PubMed2005

Lessons from the National Mental Health Integration Program.

Three projects were funded under the national Mental Health Integration Program (MHIP) in 1999, each of which employed a different model aimed at improving linkages between disparate parts of the mental health system. A national evaluation framework guided local evaluations of these projects, and this paper presents a synthesis of the findings. For providers, the projects improved working relationships, created learning opportunities and increased referral and shared care opportunities. For consumers and carers, the projects resulted in a greater range of options and increased continuity of care. For the wider system, the projects achieved significant structural and cultural change. Cost-wise, there were no increases in expenditure, and even some reductions. Many of the lessons from the projects (and their evaluations) may be generalised to other mental health settings and beyond.

Australia↗
PubMedDate not supplied

The route to a national health policy lies through the states.

National health program legislation has been becalmed in the Congress for almost 80 years. Despite periodic cries of "crisis," legislation never emerges from committee. Periodically, campaigns have been mounted without success. Tactical efforts to circumvent direct action by legislating bits and pieces of related programs, Medicare and Medicaid, health maintenance organization support, and pre-budgeting, have complicated operation of the medical care system and stimulated intractable cost inflation. For the first 150 years of American history, responsibility for public health and welfare legislation rested with the states. Most public health policies originated in a state or a few states and then later became national legislation. The state efforts were, in effect, natural experiments. After the Depression and the flood of funding from the federal government in subsequent years, the states faded as innovators. It is proposed that funding a few state models to restimulate state initiative in this regard will provide a more effective route to a national health program.

Animals↗
PubMed1995

Developing national health information in Australia.

Two significant developments in the past two years have given impetus to development of health information in Australia. In March 1993, the former National Minimum Data Set was revised and published as the National Health Data Dictionary. Second, establishment of an agreement in June 1993, between the Commonwealth and State/Territory government health authorities, the Australian Bureau of Statistics, and the Australian Institute of Health and Welfare initiated a process of working cooperatively to develop national health information. Australia, like many other countries, suffers from inconsistent health data definitions, lack of timely data, poor data quality, gaps in data coverage, and barriers to accessing the data. The National Health Information Agreement [1] came into effect on June 1, 1993 and seeks to provide a national framework and processes to improve national health information, that is, information on health of the population; determinants of the population's health; provision and utilization of health promotion and disease prevention programs and health services including: outcomes and outputs, resource use and costs, access by and distribution to population groups; relationships between these elements; and the language necessary to facilitate provision of services and collection of national health information. The major implementation mechanism of the Agreement is a rolling three-year National Health Information Work Program of national health information activities. The activities range from development work on standard hospital charts of accounts, on health outcome measures, and on new collections such as outpatients to improved definitions and the enhancement of existing collections such as mental health and vital statistics. The Work Program is published annually. A first priority is to improve the data collections available. This is being achieved through the setting of national data definitions and standards. The Agreement recognizes the National Health Data Dictionary (NHDD) as the authoritative set of national definitions and is a significant initiative aimed at improving Australia's health information. The dictionary is the repository of the agreed common language, use of the definitions facilities the description and comparison of health and health services nationally [2]. The National Health Data Dictionary currently covers institutionally provided health care, the national health labor force, and is expanding to cover other major areas, including outpatient services, community care, and mental health. The NHDD is reviewed and maintained by the National Health Data Committee and the overall coordination of definition development projects and publication is undertaken by the Institute. The placement of an agreed definition in the NHDD does not automatically mean that it has a place in a national data collection. The use of the dictionary definition will allow comparison by and between service providers. In order for a data item to be eligible for inclusion in a national minimum data set, the definition of that item must be contained in the NHDD. During the first three months of 1995, the Australian Institute of Health and Welfare will conduct a national project to develop a model for the health system in Australia. The model will provide a common vocabulary and information architecture in order to facilitate better quality health information, and consequently better health for Australians. It is expected that the development of the model will bring several benefits including facilitating the more rapid and accurate assembly of appropriate clinical information to support improved customer service and outcomes, provide a mechanism for achieving better quality information, reduce the costs of data collection; provide enabling mechanisms for the integration of systems via data standards and reduce the costs of acquiring information systems through reduced development and tailoring costs for suppliers. (abst

Australia↗
PubMed2003

[Epidemiologic reasons for screening programs in the national health service].

The author describes the current health state of the Hungarian population in terms of cancer mortality and morbidity. Based on the comparative analysis of national and international, mainly European, data he describes the unfavourable Hungarian indices trying to identify their causes and the possible breaking free from them, as well. The greatest potential lies in the organised, continuous screenings within the frame of "Johan Béla National Programme of the Decade of Health". Since tumour diseases pose severe and alarming problems in national health care the reduction of extremely high mortality in three tumour localisation (cervix uteri, breast and colorectum) by regular screenings is absolutely justified.

Europe↗
PubMed1998

Public health aspects of nutritional science in Estonia: status, research activities, and perspectives.

At the beginning of the 1990s Estonia was characterized by remarkable social and economic changes that also affected nutrition. An important step in the development of a Food and Nutrition policy was the adoption of a new 'Food Law' in February 1995. The publication of dietary recommendations followed recently. Scientific activities in Estonia are promoted by the 1993 established 'Estonian Society of Nutrition Researchers' (ESNS). The 'Ministry of Social Affairs' is of great importance for coordination of research into nutrition and it is making a great effort to connect Estonian nutrition research activities to European and international programs. An important field of scientific interest is concentrated on the nutrition of children and elderly people. With support of the 'Ministry of Social Affairs' a national health program for children and teenagers was established in which a school lunch project is integrated. Such a project has the aim to improve the quality of school lunches and to enable school teachers to conduct nutritional education. Within this national health program 1,900 schoolchildren were interviewed. This examination will also help to detect inequalities of the nutritional situation between social groups and to identify specific aims for a nutritional program in the different counties of Estonia. Health promoting units at schools will play an important role in realizing these aims. The nutritional supply and status of older persons will become an increasing problem. A survey of food supply with 429 subjects in social care facilities for older people was used to develop a new menu-planning system which meets the nutritional recommendations. Nutritional epidemiology is concentrated at the 'Department of Epidemiology and Biostatistics' of the 'Institute of Experimental and Clinical Medicine' in Tallinn. This department is also running the cancer registry of Estonia which has international reputation. Nutritional research of Estonia should aim to continue with the development of a new Food and Nutrition Policy. Important areas of activities will be concentrated on the training of young scientists, development of a food and nutrient data base, regular national nutrition and health surveys, and etiological-epidemiological studies on the basis of the Estonian Cancer Registry. The main targets of the 'Estonian Society of Nutrition Researchers' are directed to improve the scientific basis for research into nutrition and health.

Estonia↗