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PubMedDate not supplied

Health care in Nicaragua.

A two-week health study tour in Nicaragua in 1987 organized by the Health Network of the (British) Nicaragua Solidarity Campaign afforded the author of this report access to health service planning, first-hand observation of the immunization programme, and visits to centres for rehabilitation of the disabled, both from the war and civil causes. The efficacy of the low technology immunization and oral rehydration programmes is contrasted with the struggle to rehabilitate the war disabled with grossly inadequate resources.

Child↗
PubMed1996

Supporting children in need through a community-based orphan visiting programme.

There is an urgent need for programmes to be established to support the growing number of orphans in countries severely affected by AIDS. Most orphans are being cared for by extended families under difficult circumstances. Few descriptions of community-based orphan support programmes exist. We describe one such programme established in Zimbabwe in 1993. Twenty-five volunteers identified 300 orphan households. During one year, volunteers made 1725 home visits and 123 households received an average of $11 in material support or school fees. In 292 orphan households there were 702 orphans, 14.7% of children under 15 years in the area. The rate of parental deaths was increasing with 3.5% of households in the area having a parental death in 1994. Forty-five per cent of caregivers were grandparents and 33% of caregivers were over 60 years. Three per cent of orphans were cared for by adolescent siblings. The poorest orphan households were those in receipt of school fees, with out-of-school children or with an older sibling as caregiver. Community members initiated activities to help orphans. The programme described is targeted, effective and replicable. Community-based organizations such as local churches and women's groups can be mobilized to administer programmes which provide support to the poorest orphan households.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Strategies for providing care and support to children orphaned by AIDS.

As a result of the severe HIV/AIDS epidemic in sub-Saharan countries such as Zimbabwe, where between 25-30% of the adult population are estimated to be infected, there are a growing number of orphans requiring care and support. Traditionally, orphans have been absorbed within the extended family but this is becoming more difficult because of the large number of young adults dying. The burden of care and support is falling on the very young and the very old. A number of strategies have been introduced to provide this care and support. Institutions, though popular, are very expensive to run, have limited capacity and only really cater for physical needs. Interventions which simply react to those who present to them may not reach the most needy and may encourage dependency. Community-based orphan care has been identified as the best and most cost-effective way of caring for orphans. An example of a community-based orphan visiting programme is presented. In the last six months of 1996, the FOCUS programme's 88 volunteers made a total of 9,634 visits to 3,192 orphans in 798 families at an average cost of US+1.55 per visit. The key elements of such programmes have been identified. They need to be implemented by a community-based organization (CBO) within a defined community. Volunteers should be selected from within the community. They need to be trained and supported as they enumerate orphans, identify the most needy and carry out regular visits. The volunteers should keep records of all their activities. These records can then be used as a basis for monitoring the programme. In order to cope with the increasing number of orphans in resource-poor settings like Zimbabwe, it is essential that such programmes be replicated and scaled up. This not only an economic necessity but is also a way of providing appropriate and effective services to those who need them.

Child↗
PubMed1995

HIV risk behavior among Peace Corps Volunteers.

OBJECTIVE: To describe HIV risk behaviors among Peace Corps Volunteers (PCV) and to examine correlates of sexual risk behaviors. METHOD: Cross-sectional data were collected from 1242 randomly selected PCV serving in 28 countries in 1991. PCV reported the frequency of specific risk behaviors in self-administered questionnaires, which were completed anonymously and returned to the Centers for Disease Control and Prevention. RESULTS: Non-sexual HIV risk behaviors were rarely reported by PCV. Sixty-one per cent of the 1080 PCV who answered questions about sexual behavior during their Peace Corps service reported having at least one sex partner. Sixty per cent of PCV had another PCV partner, 39% had a host-country national partner, and 29% had a non-PCV expatriate partner. Overall, less than one-third (32%) of unmarried PCV used condoms during every episode of sexual intercourse; more frequent use was reported in relationships with non-steady and (for male PCV) host-country national partners. Among male PCV, condom use was positively related to lower alcohol use and the belief that HIV was a problem in the host country. Female PCV reporting more condom use with male partners were younger and had fewer partners than those reporting less use. CONCLUSION: These data indicate that PCV are at risk for acquiring HIV through unprotected vaginal intercourse. All persons who become sexually active with new partners while travelling or living abroad should be encouraged to use condoms consistently.

Adult↗
PubMedDate not supplied

Parents' evaluations of pre-school services for children with Down syndrome in two Scottish regions.

Parental evaluations of current pre-school provision for children with Down's syndrome were surveyed in two Scottish regions. Two methods were used: postal questionnaires and telephone interviews. Services covered were those provided by general practitioners, hospital specialists, health visitors, speech therapists, occupational therapists, physiotherapists, educational psychologists, home teachers, social workers and voluntary organizations. Regional differences were found in provision and in parental satisfaction with currently available services, with some of these differences being dependent on child age. Overall, parents felt they were being given insufficient professional support, with contradictory advice not uncommon. Findings indicate that if limited resources are to be used to the maximum benefit of family and child, both subjective and objective measures of the relative values of different kinds of support at different ages are urgently needed.

Child↗
PubMed1993

Maternal and child health in Indonesia.

AIIKU-HAN activity was initiated by the Imperial Gift Foundation BOSHI-AIIKU-KAI in Japan in 1936 and has been introduced and accepted to community-based maternal and child health development in Indonesia through the international cooperation project conducted by Japan International Cooperation Agency (JICA) in order to encourage community health activities carried out by Indonesian women volunteers. As AIIKU-HAN activity in Japan and Dasa Wisma health activity in Indonesia have much in common, transferring concepts, methods and experiences met less obstacles when Indonesian community health volunteers learned AIIKU-HAN activity. Experience gained while developed countries were less developed can be transferred by shifting the time-scale of history in developed countries.

Adult↗
PubMed1998

Development and evaluation of a community based, multiagency course for medical students: descriptive survey.

OBJECTIVE: To develop and evaluate an effective, community based, multiagency course (involving doctors, nurses, non-health statutory workers, and voluntary organisations) for all Leicester medical students, in response to the General Medical Council's recommendation of preparing the doctors of tomorrow to handle society's medical problems. DESIGN: Survey evaluating a task oriented, problem solving course, designed by medical students in partnership with the University of Leicester and the local community. The students, staff, and participating agencies and patients all helped in the evaluation of the first course. The students' performance on the course was also individually assessed. SETTING: Inner city housing estate with Jarman index 64.1 in Leicester. SUBJECTS: All third year medical students at Leicester University. MAIN OUTCOME MEASURES: Results of the student assignments and students' responses to a questionnaire. Results of feedback questionnaires distributed to the patients and agency representatives. RESULTS: In a two month period, 168 students completed the first course. 163 students passed the criterion referenced assignment, 50 of whom achieved an "excellent" grade. 166 completed the questionnaire, with 159 wishing to see the course continue in the present format and 149 saying that the course linked theoretical teaching with the practical experiences gained in the community. CONCLUSIONS: The University of Leicester has a viable mechanism for providing a community based, multiagency course for all its medical students. Many of the principles applied in the development and implementation of the course could be transferred to other medical schools.

Adult↗