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At least 865 records · Page 48Linked to original sources
PubMed1979

[Preventive aspects and problems of a rural health project in Chad--the need for health motivation].

Some of the main difficulties encountered in health work in developing countries depend on the sociocultural conditions. Health animatiod until now) of rural health care. Its implementation requires the training and recycling of existing health personnel as well as of parts of the population. It includes the concept of "barefoot doctor", which corresponds well to the prevailing priority health needs. One should note potential difficulties, however, for example in regard to the way the barefoot doctor is to be remunerated (the author discusses some possibilities). It isn't easy either, in practice, to mobilize the community through health education and to obtain its participation in prevention and health promotion measures. The crucial element is to win its confidence. The author describes his practical experiences in Chad in this respect. Health animation stimulates the responsabilization and the development of a prospective outlook in people, and can thus make an important contribution to their overall development efforts. It is necessary to fight factors which slow down such an evolution, among which certain habits as well as obstacles of an administrative nature.

Chad↗
PubMed1991

Reduction in total under-five mortality in western Nepal through community-based antimicrobial treatment of pneumonia.

Pneumonia is a leading cause of death among children world wide but those at highest risk in developing countries have limited access to clinical services; effective and low-cost alternatives are a global public health priority. We have done a controlled intervention trial among 13,404 children under five in Jumla, Nepal, which relied exclusively on indigenous community health workers to detect and treat pneumonia according to the World Health Organisation decision strategy, with a five-day home-treatment course of oral co-trimoxazole. No other health services were provided, and referral of children to hospital was not practicable. During the three-year study, 2101 deaths were recorded. The programme led to a 28% reduction in the risk of death from all causes by the third year of services (relative risk 0.72, 95% confidence interval 0.63-0.82), with a significant trend (p less than 0.02) of lower mortality with greater duration of the programme. The greatest benefit was among infants. In addition to reduction in deaths due to pneumonia, there was a significant reduction in deaths due to diarrhoea and measles, indicating that reduction in pneumonia morbidity had considerable carry-over effect. Our findings show that indigenous community workers can effectively detect and treat pneumonia, and reduce overall child mortality, even without other primary care activities.

Administration, Oral↗
PubMed1990

[Health promotion development as the basis for an effective health policy].

Health promotion and development are an essential part of modern and effective health care. It is based on the awareness of social health priority, it tries to develop and apply adequate methods, it is the motive for the promotion of nation-wide activities which foster health. It promotes individual efforts to improve health and contributes to the concretization and implementation of a health policy, the aim of which is to resolve basic health problems of society as a whole.

Czechoslovakia↗
PubMed2003

Case mix use in 25 countries: a migration success but international comparisons failure.

Diagnosis related groups (DRGs) were the first health management tool to group patients in clinical meaningful categories with homogeneous resources consumption. They belong to case mix measures that have been introduced in the USA in the seventies to identify clinical differences in groups of patients as well as to document variation in hospitals and physicians practices by comparing similar groups with each others. They are also used to adjust payment rates and to improve quality of care. This innovative concept migrated from the USA to several Western European countries and to Australia first, to Eastern Europe and Asia soon thereafter. The main objective in most countries concerns a hospital financing new methodology, based on similar groups of patients, by applying a global budget. The main result of this international overview of 25 countries is to show the difficulty to make international comparisons, mainly because of the absence of a universal classification system for procedures. Furthermore, diagnostic classification systems to group patients vary also by country. These obstacles to compare hospital and physician practices have profound roots in cultural differences and in political sensitivity for organising health care delivery between countries. The development of an appropriate Case Mix grouper tool including uniform diagnoses and procedures codes, leading to international use becomes a public health priority.

Diagnosis-Related Groups↗
PubMed1997

Trends in heterosexually acquired AIDS in the United States, 1988 through 1995.

We used national AIDS surveillance data to characterize trends in the numbers and proportions of heterosexually acquired AIDS cases diagnosed from January 1988 through December 1995 among adults and adolescents. We adjusted for expansion of the 1993 AIDS surveillance case definition and for delays in reporting, and we redistributed cases initially reported without risk. The chi-square test for linear trend was used to analyze trends at the p < 0.01 level by half-year of diagnosis and by sex, age, race or ethnicity, geographic region of residence at diagnosis, and partner's HIV exposure risk. From 1988 through 1995, heterosexual contact accounted for 10% of all AIDS cases. Heterosexual contact increased the most rapidly of all HIV exposure modes, with increases found among men and women in all age groups; among blacks, whites, and Hispanics: and among persons living in all geographic regions of the country. Blacks and Hispanics accounted for 75% of all persons reported with AIDS attributed to heterosexual contact. Although heterosexual contact with an injection drug user (IDU) accounted for most cases until 1993, cases increased most rapidly among persons reporting heterosexual contact with an HIV-infected partner whose risk was not specified. Findings suggest continued growth of the heterosexual AIDS epidemic. Because of the disproportionate and increasing number of heterosexually acquired AIDS cases among blacks and Hispanics, black and Hispanic communities at risk for HIV infection should be considered a high priority for prevention and education programs specifically targeting heterosexually active adolescents and adults. Epidemiologic and behavioral research and prevention program evaluation are urgent public health priorities to better control and prevent the further spread of HIV among heterosexually active adults and adolescents.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Estimating the trend of the epidemic of drug use in Italy, 1985-89.

We used data from different sources to estimate the extent and the trend of the epidemic of drug use in Italy in the second half of the '80s. During the study period, the number of subjects attending drug dependency units increased from 13,905 to 61,689. Mortality and morbidity indicators showed an increase in both drug related deaths (mainly from overdose) and AIDS cases reported in injecting drug users, particularly among older subjects. However, the number of young adults detected as drug users at the army recruitment remained virtually stable from 1986 on. These findings suggest that both demand and availability of treatment increased through the years 1985-89, and that clinical consequences of drug use related behaviour have become an important public health priority.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Policies, priorities, opportunities and barriers in mental health services: five years of the London managers' survey.

Since 1996, an annual survey of senior managers of mental health services in London has been undertaken in order to identify trends in their views of their task. This is the only longitudinal study in the current literature of the views of a group of health and social care managers in England. This paper first outlines the methods and the findings of the survey in 2000, drawing comparisons with data collected in 1998 and 1999 (and occasionally earlier). The discussion section draws out the central themes that emerge from the surveys: firstly, community mental health teams hold a central role in the mental health system; secondly, the development of trust between agencies is a complex challenge; thirdly, it appears that social care managers may be more committed to implementation of national policy than their health colleagues; fourthly, personal and organizational instability is a fact of life; and finally, the relationship between the promulgation of national policy and its adoption into local practice is not straightforward. The conclusion reflects on the potential implications of these findings for the future development of mental health services in England.

Administrative Personnel↗
PubMed1999

[Syphilis in adolescent mothers in the city of Posadas, Province of Misiones].

During three months (April to June 1997) 1,238 consecutive pregnant women were studied at the time of delivery at the Madariaga public Hospital. Syphilis was confirmed in 26 (2.1%) women, and 15 cases (57.7%) of congenital syphilis were demonstrated in newborns one of whom was a stillborn. Of the syphilitic women 61.5% were 20 years old (average), 65.4% were single, 19.2% had a stable partner and 15.4% were married; 70% of them had finished elementary school (seven years), but despite this discrete level of instruction and that they were benefited with free health attention, 73% of them had not started or completed the pregnancy control. None of these women acted as sexual workers or were drug users; 57.7% were unemployed and the remainder worked as domestic servants or were still going to school. Menarca started at 13 (average) and the age of the first sexual activity was 15 (average). The distribution of the cases of syphilis within the city area shows four clusters that coincide with the lower income population, but not with marginal groups. The failure to submit to medical control during pregnancy among syphilitic women is directly linked with an increased risk for congenital syphilis. The specific prevalence of syphilis in women (20 years old or less) pregnant or not, shows an alarming hidden epidemic situation. An interinstitutional and communitary program, with direct interventions within the detected population clusters, is now underway in order to control syphilis. Undesired pregnancy and syphilis seem to be associated with adolescent unsafe sex conducts. A coordinated program between Public Health Service and National Misiones University is operating, visiting home by home, in order to decrease or eliminate congenital syphilis and is considered a priority health problem. Unfortunately, if sexual conducts do not undergo changes in the near future, at least by the correct use of condoms, HIV will replace syphilis.

Adolescent↗