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PubMed2001

Why it is difficult to determine resource requirements for family planning.

This paper describes the efforts of Family Health International to develop a simple, standard and replicable methodology to estimate expenditures on family planning in developing countries. The study found that it is not possible, at least at this time, to develop such a methodology. Numerous problems were encountered in making expenditure estimates. First and most important, expenditure accounts are not always readily available. Even when these accounts are available, they may require some adjustments. In some instances, for example, the salaries of health workers who also provide family planning are in the health accounts, whereas in other cases the workers covered in the family planning accounts spend some of their time providing health services. Allocation variables then must be developed to separate spending on family planning from that on health. In some instances allocation variables were developed and used to separate family planning from health expenditures, but in this case allocation variables were not available and a cost analysis was performed. It is concluded that it takes considerable time and effort to estimate expenditures, and that the approach that was followed varied by country, reflecting the data available to make estimates.

Accounting↗
PubMed2002

AIDS in the Third World: how, if at all, do we help?

The duty to help our fellows is not the same, and not stringent in the same way as the familiar duties to refrain from violence to others, and to be honest. In general, being helpful to others is commendable, and to be held up as a virtue. Only in cases where reciprocity is possible and likely may we speak of anything stronger along this line. Moreover, the case of AIDS in Africa is further complicated by the fact that it is easily preventable by readily understandable behavior alterations. However, there are certain possible spin-offs, especially from mutation, which can happen when, as with AIDS, there are millions of cases. So we in the west have some further, reason for concern and action than sheer good will. What can be done is especially difficult because of cultural factors of major order. Serious investigation of how, nevertheless, to get the message across is clearly in order. Otherwise, we cannot and, as a nation, should not, try to do much more.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Ryan White CARE Act service use by Asian/Pacific Islanders and other clients in three California metropolitan areas (1997-1998).

The HIV epidemic disproportionately affects historically underserved members of racial/ethnic minorities. This paper compares HIV service use patterns for 653 Asians and Pacific Islanders (APIs) with those of other racial and ethnic minority clients (N = 28,201) at three selected Ryan White Comprehensive AIDS Resource Emergency (CARE) Act grantee sites in California. Study results show a relatively high proportion of APIs with advanced HIV disease. APIs use hospital-based HIV clinics at relatively high rates, and they use HIV case management, housing assistance, day/respite care, food/nutrition, substance abuse treatment, and health education services in relatively low numbers. Research suggests that social, cultural, and economic factors may influence health seeking behaviors and providers' practices. While there are relatively few APIs living with HIV in the US, the rate of API population growth from immigration underscores the need for service providers to take into account cultural and social factors to improve access to treatment.

Adolescent↗
PubMed2001

[Contraception in immigrant women].

The contraceptive behaviour of immigrants is not enough reliable if the great number of abortions is considered. Possible explanations for this fact are immigration itself but also the cultural background. Within the practical guidelines for transcultural contraceptive counselling, the most important points are a low access limit, the use of translators and mediators familiar with the subject, enough time and a high motivation.

Adolescent↗
PubMed2001

Making psychiatric epidemiology useful: the contribution of epidemiology to government policy.

OBJECTIVE: This paper aims to discuss the contribution of epidemiology to aspects of public policy that have either a direct influence on mental health and mental disorders, or an indirect effect by influencing environmental factors which influence mental health. Both kinds of public policy will need to be considered by governments wishing to protect, promote and improve the mental health of their populations. The paper draws on information from both relatively wealthy and low-income countries. METHOD: The paper defines epidemiology and mental health policy, sets out the range of government policies which may have an impact on mental health, and explores the ways in which epidemiology may contribute to mental health policy in relation to service inputs, processes and outcomes as well as to wider government policies. The paper also examines the advantages and disadvantages of different sources of data. RESULTS: There are a number of reasons to carry out large-scale surveys of psychiatric morbidity. First, effective policy should address the needs of the population, which can best be assessed by the epidemiology and the social and economic causes and consequences of psychiatric morbidity. Secondly, representative information in a defined geographic area can document the use of existing services and can estimate the extent of unmet needs and the services required meeting those needs. Thirdly, valid information on prevalence and associated risk factors of presumed causal importance allow aetiological hypotheses to be generated and tested and models developed for prevention. Finally, by repeating community surveys, it is possible to monitor the health of the population and trends. Epidemiological findings emphasize the importance of mental health policy addressing the key role of primary care, the social context and social consequences of disorder, the importance of addressing services for children, the need to reduce premature mortality from suicide and from physical illness. Epidemiological findings show that mental health and mental disorders are related to the environment both in its structural physical sense and in the sense of the social processes connected to and influenced by particular settings. Thus epidemiology can contribute to general policies on employment and unemployment, housing and homelessness, education and women's issues. CONCLUSION: Mental health policy is increasingly recognized as an essential area for countries wishing to enhance their economic, social and human capital. Epidemiological data are a basic prerequisite to informing such policies. Expert professional and epidemiological advice to ministries is essential if policy is to be rooted in the evidence for population needs, risk factors, effective treatments and services, and measurement of outcomes. It is therefore important to develop the capacity for policy work in the psychiatric profession by including public health, epidemiology and policy placements for young psychiatrists.

Child↗
PubMed1999

NIH drops PhD plan.

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Computational Biology↗