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At least 559 records · Page 31Linked to original sources
PubMed1994

Geographic imbalances of physician supply: an international comparison.

This study was undertaken to compare geographic imbalances of physician manpower in developed and developing countries and to evaluate the success of policies designed to alleviate the imbalances. Data were drawn from a mail survey of countries conducted by the World Health Organization, from national statistical summaries, and from published information on national policies and programs. Information was available from 26 developing countries and 15 developed countries. Among developing countries, the degree of urbanization and rural economic development appeared to be the most important determinants of the level of geographic imbalance. Among developed countries, those with very high overall physician/population ratios tended to have the least degree of imbalance, but this effect was not consistent. At the national level in most countries, the effect of policies or programs specifically designed to redistribute physician manpower appeared to be limited.

Developing Countries↗
PubMed1986

The development and implementation of a rural consortium program to provide early, preventive school mental health services.

This article describes the development and implementation of a rural consortium of school-based programs for early detection and prevention of maladjustment. The program expanded considerably the reach of early services to young children. It also stimulated communication, interaction and support among professionals in participating districts. Program evaluation data provided evidence of its efficacy. Extensions of the consortium model to other rural districts are reported and the utility of the approach for addressing the mental health problems of children in under-resourced rural school districts is considered.

Acting Out↗
PubMed1981

Incidence and severity of rotavirus and Escherichia coli diarrhoea in rural Bangladesh. Implications for vaccine development.

In a 1 year study of diarrhoea in a village in rural Bangladesh, enterotoxigenic Escherichia coli (ETEC) were the most frequently detected enteropathogens; shigellae were the second most commonly detected enteropathogens and rotaviruses the third. ETEC and rotavirus were found in 31% of diarrhoea episodes experienced by children aged less than 2 years and in 70% of episodes associated with dehydration. Furthermore these two pathogens were identified in the stools of 77% of young children with life-threatening dehydration seen at a diarrhoea treatment centre. The association of ETEC and rotavirus with such a substantial proportion of cases of dehydrating diarrhoea suggests that immunoprophylaxis to reduce the high incidence of deaths from diarrhoea in developing countries may be feasible and that vaccine development should concentrate on these two enteropathogens.

Bangladesh↗
PubMed1998

Nutritional status, psychosocial development and the home environment of Indian rural children.

OBJECTIVE: To assess the psychosocial development of well nourished and malnourished children aged 0-6 years and to identify the microenvironmental factors influencing their growth and development. DESIGN: Multicentric cross-sectional. SETTING: Rural Communities. SUBJECTS: Total of 3668 children of whom 2212 were well nourished and 1456 were malnourished. METHODS: Weight for age index to assess nutritional status. Cut-off < 75% NCHS standards used based on Gomez grades II and III being malnourished and Normal and grade I being well nourished. ICMR Developmental Screening Test to assess psychosocial development and modified WHO parental interview schedule to assess family and micro-environmental factors. RESULTS: Malnourished children attained developmental milestones at a later age. Developmental delay among the malnourished was especially observed in areas like vision and fine motor, language and comprehension and personal social. The delay was to the extent of 7-11 months in these areas in different age groups. Paternal involvement with child care especially, father spending time, telling stories and taking child for outing was found to be important for positive psychosocial development. Other significant factors included parents teaching child, small family size and paternal occupation. Child's appetite, absence of health problems, parental age and family having own house and electricity were the factors significantly related to better nutritional status of children. CONCLUSION: Factors identified in the study are important for the development of relevant intervention at the home level. Appropriate multifaceted community based programmes such as the ICDS are also required for stimulating growth and development of backward rural children.

Child↗
PubMed2006

Psychosocial stimulation improves the development of undernourished children in rural Bangladesh.

Undernutrition in early childhood is associated with poor mental development and affects 45% of children in Bangladesh. Although limited evidence shows that psychosocial stimulation can reduce the deficits, no such interventions have been reported from Bangladesh. The Bangladesh Integrated Nutrition Program (BINP) has provided nutrition supplementation to undernourished children through community nutrition centers (CNCs). We added psychosocial stimulation to the treatment of undernourished children in a randomized controlled trial to assess the effects on children's development and growth and mothers' knowledge. Twenty CNCs were randomly assigned to intervention or control groups with 107 children in each group. We also studied 107 nonintervened better-nourished children from the same villages. Pre- and postintervention measurements included children's height, weight, development assessed on Bayley Scales, behavior ratings during the test, and a questionnaire on mothers' knowledge of childrearing. The intervention comprised home visits and group meetings with mothers and children for 12 mo. Intervention benefited children's mental development (4.6 +/- 2.0, P = 0.02), vocalization (0.48 +/- 0.23, P = 0.04), cooperation (0.45 +/- 0.16, P = 0.005), response-to-examiner (0.50 +/- 0.15, P = 0.001), emotional tone (0.33 +/- 0.15, P = 0.03), and mothers' knowledge (3.5 +/- 0.49, P < 0.001). At the end, undernourished controls had poorer mental (-4.6 +/- 2.0, P = 0.02) and motor (-6.6 +/- 2.2, P = 0.003) development, were more inhibited (-0.35 +/- 0.16, P = 0.03), fussier (-0.57 +/- 0.16, P < 0.001), less cooperative (-0.48 +/- 0.17, P = 0.005), and less vocal (-0.76 +/- 0.23, P = 0.001) than better-nourished children. Intervened children scored lower only in motor development (-4.4 +/- 2.3, P = 0.049). Neither group of undernourished children improved in nutritional status, indicating that treatment had no effect. In conclusion, adding child development activities to the BINP improved children's development and behavior and their mothers' knowledge; however, the lack of improvement in growth needs to be examined further.

Anthropometry↗