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PubMed2002

The role of dams in development.

Dams are a major issue in sustainable management of finite water resources; they have also become the subject of vigorous public debate. This article considers them in the light of the report of the World Commission on Dams and using the example of Turkey. It is argued that economic development and population growth, particularly in arid and semi-arid regions, make plain the need for dams for hydropower and irrigation. Environmental impact assessment is essential, as are effective programmes for resettlement to avoid the impoverishment of displaced people.

Agriculture↗

PubMed2003

Surviving the impact of HIV-related illness in the Zambian business sector.

The HIV epidemic in sub-Saharan Africa represents an obstacle to productive employment and economic development. Employers in the region are experiencing severe staff shortages, reduced productivity, and increased costs because of protracted ill health and death among their workforce. The scale of the problem has not been fully estimated and the extent to which it could be ameliorated by control measures including effective treatment of opportunistic infections is not well known. Employers and employees (n = 108) in seven Zambian firms were interviewed to assess direct and indirect costs of illness to the firms. Information was collected on diagnosis and treatment received, duration of illness, time off, and strategies adopted to compensate for absent workers using a combination of questionnaires, structured interviews and focus group discussions. The main causes of ill health were tuberculosis (TB) (46.8%), diarrhea (12.9%), and sexually transmitted diseases (STDs; 5.8%). Annual treatment costs to the firm ranged from Zambia Kwacha (K) 60,000 to 405,000 per person treated. Other firm costs included productivity losses because of ill health, paid sick leave, the cost of employee replacement, and funerals. Employees incurred K 67,773 on average per illness episode. The most common causes of ill health were those most frequently associated with HIV. They can be easily but were often ineffectively treated. Improving disease management would thus reduce wastage and costs both to employer and employee. The extent of the impact in these firms shows the need for the private sector to adopt a stronger role in prevention and care. Further research is required to assess what recommended treatment options might be, how they could be financed, and the extent of the economic impact of HIV on firms. This would foster the development of more appropriate responses to the epidemic in Zambia and the region as a whole.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Mortality and morbidity transition in Kuwait: the role of health and development policies.

Kuwait has, in recent years, achieved a marked improvement in the health status of its population, as measured by a variety of mortality and morbidity indicators. This can be attributed to the implementation of two sets of policies that impact upon health, namely the health and socio-economic development plans of the Kuwaiti government. This article seeks to outline these recent changes in mortality and morbidity levels, and traces out the key policies considered to be the major determinants for these changes. Data is presented on health status, and on patterns and trends of health services' utilization. These trends suggest strongly that, for Kuwait, the health goals set for the year 2000 are achievable.

Health Policy↗

PubMed2003

Azerbaijan: environmental conditions and outlook.

The author describes present environmental conditions in Azerbaijan in relation to the Soviet legacy and measures taken since independence. Environmental projects have been financed largely by international organizations and foreign companies. The most serious problems are contaminants in the Caspian Sea; air, water, and soil pollution in Sumgait; illegal fishing; poor quality of drinking water; cutting of forests for fuel and pasture; overgrazing; and soil erosion and salinization. Progress in developing an environmental conscience, necessary for sustained protection of the environment, will depend most importantly on environmental education, growth of democratic institutions and attitudes that encourage both governmental and citizen responsibility for the environment, and economic development that produces a substantial middle class. Positive advances include a Constitution and laws that require protection of the environment, and individuals who speak out for environmental care. Negative factors include poverty and the present government's low priority for environmental protection.

Azerbaijan↗

PubMed2002

[Vaccines against poverty].

In spite of major technological advances during the past ten years, the gap between rich and poor countries remains considerable. Among the 10.5 million children deaths in 1995, 99% occurred in developing countries and 1% in industrialised ones. Only 5 diseases (pneumonia, diarrhoea, measles, malaria and AIDS), as well as malnutrition, are responsible for more than 60% of the deaths. Most of them could be averted by an equitable access to health care and efficacious prevention programmes in the community. Every year, 3 million children are saved thanks to routine vaccinations, but also 4 millions die because they are not immunised, and this almost exclusively in developing countries. It is therefore urgent to develop strategies aimed at reaching the poorest of the poor, in order to reduce the burden of disease in these population and contribute thus to the well-being of families and to a sustainable economical development.

Acquired Immunodeficiency Syndrome↗

PubMed1989

[A system of introduction of the results of scientific research on hygiene into practical health care and national economics].

The country's socio-economic development necessitates further elaboration of new approaches to the introduction of hygienic research results into practice. The main criterion for choosing proper research techniques lies in their economy-type efficiency, both social, medical and economic. A new system of hygienic research introduction should be based on financial and economic stimuli, establishment of a network of inventive firms, as well as supported by an effective mechanisms of information feed-back with due account of health indices.

Delivery of Health Care↗

PubMed1976

Cultural diversity in central America and Panama: its relationship to conservation and planning.

The most frequently overlooked aspect of conservation of natural resources and economic development is human cultural diversity. However, conservation and development of natural resources are basically human-oriented endeavors and all conservation and developmental efforts ought to start with a clear understanding of the varied needs of the people. In addition, cultural diversity is a natural resource that ought to be protected along with all the more commonly recognized resources of the ecosystems of which humans form an integral part. Cultural diversity in a large measure is an ecological phenomenon because such diversity includes variations in the ways different people perceive and utilize the environments in which they live. Thus, cultural diversity, in large measure, equates with ecological diversity. It has been well established that a high degree of ecological diversity (including taxonomic, niche, biogeochemical and other measures of diversity) is a necessary attribute of humid tropical ecosystems if such ecosystems are to remain viable over long periods of time. The current land-use trends in Central America and Panama are leading toward ever larger areas being devoted to monocultural use with sharply reduced ecological diversity that poses great dangers for the near and long terms. In addition, the resultant removal of people from rural areas results in growing social, economic and political problems, that are not being successfully met by developing nations. Not only is there a growing wastage of human resources, a weakening of the social structures, and an increasing and dangerous dependence upon monocultures oriented toward export markets, but the ecological diversity of the previous existing land-use systems are being lost. This kind of diversity is probably no less valuable to the ecological health of a nation's agriculture, forestry, and general resource utilization than is the genetic diversity of "primitive" crop plant varieties which biologists now recognize and increasingly seek to preserve as "modern" crop plant varieties become ever more simple genetically and hence ever more vulnerable to disease and other perturbations.

Agriculture↗

PubMed1995

Variations in poverty and health between slum settlements: contradictory findings from Visakhapatnam, India.

Whilst much work has been done to highlight the plight of the urban poor in less developed countries, little information exists about differences in health between poor urban areas. This paper describes environmental and other health hazards in five slum settlements in Visakhapatnam, India. Despite considerable differences in infrastructural and socio-economic development, morbidity rates were not found to vary between the study settlements. Methodological and epidemiological explanations for this lack of variation are discussed.

Accidents, Home↗

PubMed2003

Development of sustainability indicators by communities in China: a case study of Chongming County, Shanghai.

Public participation as a means of identifying sustainability indicators for Chongming County, Shanghai, China was evaluated by an international group drawing on established best practice. An initial 'long list' of 86 sustainability indicators, based on previous indicator systems developed in China, was identified. This 'long list' was reduced via consultations with local academics and local-government officers from Shanghai City and Chongming County to a 'short list' of 17 indicators. This short-list was subjected to further community consultation involving 159 local-government officers, teachers, students (aged 12-14 years), farmers and workers. Data from the consultations indicated differences in the understanding of sustainable development among the different sectors. By combining the data from the different sectors it was possible to identify a consensus around 4 core and 7 additional indicators. These are proposed as indicators which could be used to steer local activities directed towards sustainable development. The list of indicators produced by the people of Chongming Island was compared to local indicator systems in Europe. In comparison with European lists the Chongming list was found to have a greater emphasis on economic development but a similar level of concern for environmental matters. This study has special significance as it reports on the implementation of a process involving local resident participation in the process of sustainable development in China.

Adolescent↗

PubMedDate not supplied

Abandoning the retentionist model: family and marriage change among the East Indians in rural Trinidad.

East Indian family life in rural Trinidad is usually analyzed within the framework of the retentionist model, which holds that the East Indians have successfully retained the basic institutions of their home culture. A restudy of Felicity village demonstrates that the model underestimates the impact of social and economic developments on family and marriage life in this community because it focuses mainly on ideal patterns of culture.

Culture↗

PubMed2001

Perinatal problems in developing countries: lessons learned and future challenges.

Every year, approximately 600,000 women die of pregnancy-related causes--98% of these deaths occur in developing countries. Complications of pregnancy and childbirth are the leading cause of death and disability among women of reproductive age in developing countries. Of all human development indicators, the maternal mortality ratio shows the greatest discrepancy between developed and developing countries. In fact, maternal mortality itself contributes to underdevelopment, because of its severe impact on the lives of young children, the family and society in general. Furthermore, in addition to more than half a million maternal deaths each year 7 million perinatal deaths are recorded and 8 million infants die during the first year of life. Maternal morbidity and mortality as well as perinatal mortality can be reduced through the synergistic effect of combined interventions, without first attaining high levels of economic development. These include: education for all; universal access to basic health services and nutrition before, during and after childbirth; access to family planning services; attendance at birth by professional health workers and access to good quality care in case of complications; and policies that raise women's social and economic status, and their access to property, as well as the labor force.

Developing Countries↗

PubMed2002

Coral reef health and effects of socio-economic factors in Fiji and Cook Islands.

This research focuses on coral reef health in the South Pacific region, an area of high global coral diversity. Coral reef health surrounding four island case studies in the Cook Islands and Fiji have been assessed in areas that have not been previously surveyed. This study compares four islands with barrier and fringing reefs that have different levels of economic development, population pressure, land-use practices, and marine management practices. This interdisciplinary research methodology includes both ecological and social data collection to further understanding of human environment interactions. In comparing the reefs with different socio-economic factors, this research shows that reefs with traditional systems of resources management are healthier, population pressure is not the main factor causing the demise of the reefs and agro-industry is the main industry causing the degradation of the reef in these four South Pacific Islands. In addition, researchers need to use a whole reef perspective to examine coral reef health.

Animals↗

PubMed2006

The implications of shortages of health professionals for maternal health in sub-saharan Africa.

This paper discusses the implications of shortages of midwives, nurses and doctors for maternal health and health services in sub-Saharan Africa, and inequitable distribution of maternal health professionals between geographic areas and health facilities. Shortages of health professionals reduce the number of facilities equipped to offer emergency obstetric care 24 hours a day, and are significantly related to quality of care and maternal mortality rates. Some countries are experiencing depletion of their workforces due to emigration and HIV-related illness. Another feature is the movement from public to private health facilities, and to international health and development organisations. The availability of skilled birth attendants and emergency obstetric care may be reduced due to understaffing, particularly in rural, poor areas. The existing workforce may experience increased workloads and job dissatisfaction, and may have to undertake tasks for which they are not trained. If governments and development partners are serious about reaching the Millennium Development Goal on maternal health, substantial numbers of professionals with midwifery skills will be needed. Shortages of maternal health professionals should be addressed within overall human resources policy. A rethink of health sector reforms and macro-economic development policies is called for, to focus on equity and strengthening the role of the state.

Africa South of the Sahara↗

PubMedDate not supplied

What is next for pharmacoeconomics and outcomes research in Asia?

OBJECTIVES: Pharmacoeconomics and outcomes research have the potential for rapid adoption in the Asia Pacific region. Nevertheless, the region is characterized by great diversity in social and economic development, ethnicity, population size, health-care system, culture, language, and religion. Thus, the rate of adoption is also quite diverse across the region. METHODS: Among the countries reviewed in this article, governments take varying levels of interest in applying this research in health policy decisions. For example, some countries have already implemented systems that require pharmacoeconomic studies as one component of a new pharmaceutical product's approval for reimbursement, whereas others recommend such data but do not require it in policy and medical decision making. The literature in the countries reviewed is actually quite robust given the early stages of development of this field in most countries. The academic community has members trained in this field of research in all the countries reviewed and some universities have established departments whereas others have just introduced a few classes in the area. RESULTS: At the moment, pharmacoeconomics and outcomes research are being conducted mainly by academics. In addition, some pharmaceutical researchers are active and pharmaceutical companies are currently preparing to conduct more of this research as part of their strategy for Asian drug development. CONCLUSIONS: Prospects for future growth and development in this field are quite good in Asia as rapid healthcare inflation, increasing rates of chronic conditions and aging population, and increasing technology diffusion will underpin the need for greater awareness of the need to incorporate economic efficiency into the health-care systems.

Aged↗

PubMed1995

A logit analysis of the likelihood of leaving rural settings for registered nurses.

This study examined the net effects of individual and community factors on the likelihood of registered nurses leaving current jobs using a logit analysis. Based on data from a survey of 2,509 rural nurses, four separate models were estimated and compared: one for nurses in rural settings as a whole and the other three for nurses in hospitals, skilled nursing facilities, and community/public health agencies. Results of the general model indicated that nurses' marital status, age, position, income, job satisfaction, and satisfaction with the community were significant determinants of the likelihood of leaving current jobs. Job satisfaction was the most significant factor, followed by satisfaction with the community. Findings from the models for three different employment settings were similar to those of the general model. However, the significance of factors and their strength of effect on nurses' decisions to leave or stay in their current jobs differed across the three types of facilities. Based on these findings rural nursing administrators and policy-makers should give priority to retention strategies that focus on improving the job environment. The development of different strategies for different groups of nurses (i.e., by age or marital status) and different types of facilities should increase the benefit/cost ratio. In addition, programs that involve rural health care agencies in community and economic development should be further explored as an avenue to increased nurse retention in rural areas.

Adult↗

PubMed2002

The global HIV/AIDS pandemic, structural inequalities, and the politics of international health.

In spite of recent advances in treatment and care available in most developed countries, the HIV/AIDS pandemic continues to spread throughout the developing world. Structural inequalities continue to fuel the epidemic in all societies, and HIV infection has increasingly been concentrated in the poorest, most marginalized sectors of society in all countries. The relationship between HIV/AIDS and social and economic development has therefore become a central point in policy discussions about the most effective responses to the epidemic. Important progress has been made in recent United Nations initiatives. Maintaining long-term commitment to initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria is especially important in the wake of September 11 and ensuing events, which threaten to redirect necessary resources to seemingly more urgent security concerns.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

[Academic medicine and gender: women in surgical specialities].

Scientific advances have always been used as a measure to place societies in the context of developed and developing countries. This circumstance has directly influenced the division among the sexes and among social strata. Traditionally women have been relegated to an inferior status and in some instances their role as active participants in social and economic development has been annulled. In professional spheres, women have reached positions that previously seemed unattainable due to social and cultural limitations imposed by men and sometimes by women themselves. Medical school is currently no longer an obstacle for women to gain entry to, approximately 50% of medical students are women. On the other hand, surgical residences constitute a more complex situation. In order for women to decide to apply to a surgical residence, they have to take into account a variety of factors, among them, the difficulty of joining a male dominated environment where women have to demonstrate they are able and capable of performing sometimes at the expense of having to carry an additional work load. Women admitted to surgical residences will have to face gender discrimination, pregnancy and family responsibilities as well as salary inequities and sometimes even sexual harassment. We aimed to show the circumstances and obstacles that women are confronted with during surgical training and the influence these have in their personal and professional development.

Female↗

PubMed1988

Monkeypox virus: ecology and public health significance.

Recent investigations have revealed that monkeypox virus infections occur with a high prevalence in several species of squirrels belonging to the genus Funisciurus, less frequently in squirrels of the genus Heliosciurus, and rarely in forest-dwelling primates. These squirrels commonly inhabit the secondary forests around human settlements in the rural areas of Zaire, especially where oil palms are grown, and are rare in the primary rain forest.Human infection with monkeypox virus occurs most frequently in the 5-9-year-old age group, particularly in small villages where the children hunt and eat squirrels and other small mammals. As the populations are now increasing in number and can no longer feed on wild life alone for their animal protein requirements, the development of animal husbandry as a source of meat will certainly decrease the risk and the incidence of human monkeypox, even in areas where monkeypox virus is present in the local population of squirrels.Although population growth and economic development in western and central Africa will probably reduce the risk of human infection with monkeypox virus, visitors to these areas who are likely to come into contact with wild animals should be offered smallpox vaccination as a protection.

Animals↗