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Indicators to monitor progress of National Iodine Deficiency Disorders Control Programme (NIDDCP) and some observations on iodised salt in west Bengal.

Iodine Deficiency Disorders (IDD) are widely prevalent in our country and their consequences for human development are well known. The scope of National Goitre Control Programme (NGCP) launched in 1962 was expanded and the programme was renamed as National Iodine Deficiency Disorders Control Programme (NIDDCP) to connote wider implications of iodine deficiency in population. It is necessary to monitor the progress of NIDDCP using quantifiable indicators to ensure achievement of programme objectives. Prevalence of iodine deficiency disorders, status of iodised salt and level of knowledge. Attitude & practice (KAP) of community regarding IDD and iodised salt are a few such indicators. Children in the age group of 8-10 years are considered most appropriate target group to monitor IDD prevalence. The quality of iodised salt assessed at various levels in West Bengal (using field testing kit) indicated 'satisfactory' iodine content (i.e. > or = 15 ppm) at wholesalers (84.3 per cent), retailers (74.3 per cent) and consumers (71.2 per cent) level. It is suggested that the quality of iodised salt should be periodically assessed and intensive educational campaigns on IDD be launched to create increased demand for consumption of iodised salt in the community.

Adolescent↗

National Iodine Deficiency Disorders Control Programme in India.

Iodine Deficiency Disorders are one of the biggest worldwide public health problem of today. Their effect is hidden and profound affecting the quality of human life. An attempt has been made to describe the various aspects of the National Iodine Deficiency Disorders control Programme (NIDDCP) being implemented in the country. The paper also focuses about the problems associated in implementing this national programme.

Adolescent↗

Multisectoral strategy for AIDS prevention at community level.

In north-east Thailand a five-act drama is broadcast on the village sound system to catalyse involvement in planning and carrying out AIDS prevention activities. Each community's own suggestions for an effective strategy are presented to the relevant government and nongovernmental agencies for endorsement and support.

Community Health Services↗

Development of a Dietary Exposure Potential Model for evaluating dietary exposure to chemical residues in food.

The Dietary Exposure Potential Model (DEPM) is a computer-based model developed for estimating dietary exposure to chemical residues in food. The DEPM is based on food consumption data from the 1987-1988 Nationwide Food Consumption Survey (NFCS) administered by the United States Department of Agriculture (USDA) and on residue data from government-sponsored monitoring programs. Foods reported in the NFCS were categorized into exposure core foods (ECFs). A computer program for DOS-based personal computers was developed to link consumption of the ECFs with residue values observed in the foods. The data files utilized by the DEPM were designed in dBASE IV with FoxPro for Windows applications programs for queries and reporting. The program calculates exposure estimates for categories of core foods, such as grain dishes, fruits, or vegetables; for individual core foods, such as wheat and apple combination dishes; and for individual foods, such as apples or carrots. The program, residue summary databases, and core food consumption database permit the analyst to evaluate potential exposure of several population groups to various chemicals via the diet. The DEPM is not intended for risk assessments, but is a suitable tool for identifying data gaps and establishing priorities for research, and for identifying potentially significant foods for human exposure monitoring.

Adult↗

Sexually transmitted disease control in China (1949-1994).

This paper summarizes the historical experiences in venereal disease control in China during the 1950s. Venereal diseases had been all but eliminated in the whole country till 1964. However, along with the implementation of open-door policy and economic reform in the 1980s, the social environment was changed to a great extent in this country. Sexually transmitted diseases (STDs) were re-introduced in the Chinese mainland and new foci of infection established themselves in some cities. During the recent 8 years the national STD case-reporting and sentinel surveillance systems have been set up. The results of surveillance show that the annual incidence of STD has been on the increase. The existing factors associated with the increasing incidence of STD mainly are; population movement, increasing affluence in a part of population, the availability of multiple sexual partners (including the prostitution) and asymptomatic STD increased. Finally, the strategies for STD control are discussed in detail.

China↗

Partnership for primary care.

A project for improving primary health care in an underserved rural area of Osun State, Nigeria, involved the creation of a partnership between the local government, the community and a medical college. Joint administrative and technical committees were established, and community mobilization was fostered. The evidence so far indicates that partnership designs can accelerate the development of primary health care in an affordable manner.

Humans↗

Trends in attitudes and behaviour relevant to AIDS in Ugandan community.

Behaviour-related preventive measures are still the main weapon against the spread of AIDS. Intensive AIDS prevention and control activities conducted over the last ten years need to be evaluated on the basis of their impact on attitudes and behaviour relevant to AIDS. The main objective of this study was to document and evaluate trends in attitudes and behaviour relevant to AIDS in a Ugandan community over a seven year follow up period. The study was a longitudinal community-based closed cohort. Periodic surveys were conducted on the study group and data on condom use, attitudes about condoms, rates of sexual partner change and reported frequency of sexually transmitted diseases were collected in all surveys. Data reported are from surveys conducted during 1987, 1992 and 1994 in which similar questions were asked and emerging trends identified. Reported condom use ever, increased from 3.9% in 1987 to 10.1% in 1992 and to 27.2% in 1994. This is a 7.3 fold increase over seven years. In females, reported use of condoms increased from 1.2% in 1987 to 18.2% in 1994 while in males it increased from 6.9% to 35.3% over the same period. In this study group there are still more people opposed to the ongoing intensive condom campaign than there are those supporting it. The percentage supporting the campaign was 28% in 1987, 26% in 1992 and 40.8% in 1994. This is a rising trend. The rate of sexual partner change has declined. During the baseline survey, 26.5% of the respondents reported that they had intercourse with two or more sexual partners in the six months period before the interview. This proportion decreased to 6.8% in 1992 but then increased to 17.1% in 1994. During the baseline survey, 2.6% of the study group reported that they had sexual intercourse with six or more partners during the six months period before the interview but during the 1992 and 1994 surveys, no one reported sexual intercourse with more than five partners during a similar period. The reported frequency of sexually transmitted diseases during a twelve month recall period, reflecting STD incidence, decreased from 3.5% in 1992 to 1.9% in 1994. In conclusion during the seven year followup period of this community-based closed cohort, we have identified a sharp increase in condom use, a reduced rate of sexual partner change and a decline in the reported frequency of sexually transmitted disease. The percentage of people supporting the condom campaign is rising. These are some of the outstanding outcomes of the AIDS prevention activities conducted in the country over the last 10 years.

Acquired Immunodeficiency Syndrome↗

Is Medicaid pronatalist? The effect of eligibility expansions on abortions and births.

CONTEXT: Income thresholds for Medicaid eligibility for pregnant women were raised in two phases between 1987 and 1991. During roughly the same period, the U.S. fertility rate rose and the abortion rate declined; changes were particularly marked among young women, raising the possibility that fertility increases were related to Medicaid expansions. METHODS: Pooled time-series cross-section regressions were used to examine the effects of the Medicaid eligibility expansions in 15 states on rates of abortions and births among unmarried women aged 19-27 with 12 or fewer years of schooling. Abortion data came from the National Center for Health Statistics or state health departments and were aggregated by women's age, race, marital status and schooling; data on births were from national natality tapes. RESULTS: The Medicaid expansions were associated with a 5% increase in the birthrate among white women, but did not influence the rate among black women. Overall, no effect on the abortion rate was evident, but in analyses restricted to a subsample of eight states with the most complete abortion data, the rate among white women showed a significant decline after the second phase of expansions. CONCLUSIONS: Subsidized health care for low-income pregnant women in these 15 states may have encouraged white women to have more children than they would have without coverage.

Abortion, Legal↗