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The public immunisation programs of 14 local government councils in Sydney's Western Region were examined to determine those variables which might predict an effective program. Independent variables included the demographic characteristics of the populations being served, as well as relevant aspects of each council's clinic program and administrative input. The dependent variables were three indices of immunisation reflecting the proportion of the 0-5 population reached by the public immunisation service. One variable, the amount of staff time spent on administration, was best able to explain the variance in public clinic immunisation rates across the local government areas. Components of effective staff time were examined and the results are discussed in relation to the planning and promotion of public immunisation programs.
Analysing the evidences for local concern with health in the various historical phases of the organization of social life, especially relating to the discussion of the efficacy of the social rights written into some contemporary constitutions, the attempt is made to define the responsibility for the guarantee of the right to health. The possibility of defining the responsibility for the guarantee of social rights arises directly from the legal definition of such rights, practicable at the level of local government. Thus, after a thorough examination of the Brazilian constitutional organization in search of the guarantee of health for all, it is concluded that the promotion of the said responsibility is greatly favored, since Municipal competence regarding issues related to health are listed and discussed there in detail.
This Article analyzes the development and complexities of the antitrust state action doctrine and the Local Government Antitrust Act as these doctrines apply to both "municipalities" and private entities. The restructuring of a public hospital is used as a model to facilitate the antitrust analysis. The restructuring model, which typically involves the leasing of a hospital facility by a public entity to a private nonprofit corporation, offers the unique opportunity to compare the different standards employed under the state action doctrine and the Local Government Antitrust Act. As a practical matter, the Article provides a framework for a public hospital to evaluate the impact of corporate restructuring on its antitrust liability exposure and to develop strategies to minimize antitrust risks.
Between January and August 1984, a total of 1,555 Primary school children aged 4-18 years were surveyed for tinea capitis in Awka local government area of Anambra State, Nigeria. Specimens for mycological investigations were aseptically collected from 300 children showing evidence of tinea capitis and processed by standard method. A total of 158 (10.2%) mycologically proven cases of tinea capitis were detected. Prevalence of tinea capitis was higher in younger children (12.0%) aged 4-10 years than in older children (5.3%). Prevalence of 3.8% recorded for children over fifteen years of age. The species of dermatophytes Isolated were Microsporum audouini 38.0%, Trichophyton mentagrophytes (24%), Trichophyton soudanense (15%), Trichophyton tonsurans, (9%), Trichophyton Schoenlenii (9%) and Microsporum gypseum (5%). Overcrowding and poor sanitary living conditions were found to be factors favouring occurrance of tinea capitis in Awka local government area of Anambra State.
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OBJECTIVE: To determine the magnitude of differentials in mortality and hospital morbidity by Local Government Area (LGA) in Sydney (1985-1988), and to correlate these with LGA indicators of socioeconomic status. DESIGN: Cross-sectional group-based comparative study of mortality and hospital separations, and a group-based correlations analysis in relation to socioeconomic indicators. OUTCOME MEASURES: Mortality--life expectancy at birth, infant mortality, 0- to 4-year mortality, age-standardised 15- to 64-year mortality (all-cause and various causes), sex-specific (except infant and 0- to 4-year mortality). Hospital morbidity rates--0- to 4-year hospital separations, age-standardised 15- to 64-year hospital separations (all-cause and various causes), sex-specific. STUDY FACTORS: Census-derived LGA proportions of immigrants, Aborigines, professionals, unskilled workers, unemployed persons, those with a university degree and those having no qualifications, and the composite Ross Indicator. RESULTS: Considerable differences in mortality and hospital morbidity by LGA in Sydney were found. Males had higher mortality and lower rates of hospital separation than females. LGA differentials were most obvious for adults, with little variation noted for infants or children. Most socioeconomic indicators were highly correlated with adult mortality and hospital morbidity in the expected direction, particularly indicators of low socioeconomic status. The unemployment rate, proportion Aboriginal, proportion unskilled, proportion unqualified, and the Ross Indicator were the most highly correlated variables. CONCLUSIONS: There are persistent differentials by LGA in mortality and hospital morbidity in Sydney which are strongly associated with socioeconomic status. The Ross Indicator was found to be a useful composite indicator. The high correlations of mortality and hospital morbidity with the unemployment rate raise the question of to what extent this is due to illness and premature mortality in the unemployed. Monitoring of health status differentials needs to continue if progress towards Health For All targets is to be evaluated.
In the course of a survey of gastro-intestinal parasites among humans in Iwo Local Government area in South-Western Nigeria, eggs of helminths found were those of Ascaris lumbricoides, Necator americanus, Trichuria trichiura and Strongyloides stercoralis while protozoan cysts encountered were those of Entamoeba histolytica and Entamoeba coli. About 51% of the 283 faecal samples were positive for parasitic ova or cysts and 24% possessed mixed infection. Incidence of Ascaris was highest followed by Trichuris and Necator. Peak of Ascaris infection was among the 1-10 years age group while that of hookworm and Trichuris was in the 11-20 years age-group. Sixteen (16) combination of mixed infections were found of which that of hookworm and Trichuris was the commonest. Incidence of polyparasitism increases with age until it reached a peak in the 21-40 years age-group.
Because of health care inequities that still persist under federal and state sponsorship plans, many local government agencies are starting to consider ways of directly providing medical services to the poor. Over 100 years' experience with direct provision programs in the City of Cincinnati, however, have been ultimately counterproductive. A unique three-way contract developed by the Board of Health, a private multispecialty physicians' group and a consumer advocate organization has recently allowed Cincinnati to implement a delivery system that integrates mechanisms for prepaid public health care into a fee-for-service private group practice, all within the context of a community-based neighborhood health care facility. While it is still too early to make a full evaluation of this public health care group practice model, there are already indications that is services will be superior to those offered in Cincinnati's traditional public clinics.
The major health agencies of local urban governments--public health department and public hospital--are often dismissed as "irrelevant" or attacked as "unresponsive". The rush to reform through reorganization hasn't often addressed the underlying problems of an eroded tax base, an indifferent federal policy, and intra-professional disputes. Newer corrective steps are called for if complex demands for public and personal service are to be met.
"Prior Notification" policies have elicited fears of community opposition from agencies who have adopted a "low profile" approach in locating community-based residential facilities. Nevertheless, data from a survey of New Jersey community care providers indicate that local government officials express less opposition when informed of the proposed location and invited to meet with the provider. Arranging to meet with local officials is most important when neighbors have leadership, since officials express more intense opposition when neighbors invite them to a meeting. The literature has already established the fact that meeting with neighbors can facilitate mobilization and thereby engender more intense opposition, both from neighbors and from local officials. Hence, the available evidence suggests that providers should meet with local officials to discuss the community care program but should attempt to deal with neighbors individually. This strategy is compatible with the policy of "prior notification" adopted in New Jersey.
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