World health statistics quarterly. Rapport trimestriel de statistiques sanitaires mondiales
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World Health Stat Q · Jan 1993
Health in the central and eastern countries of the WHO European Region: an overview.
The enormous social, political and economic changes that began in the CCEE/NIS in the late 1980s included the revelation and public discussion of a widening health gap between these countries and the other Member States of the European Region. The continuing economic problems and their effects on health increase the urgency of the need for assistance from the international community. Diverging trends in life expectancy became evident in the mid-1970s, and the gap continued to widen in the 1980s for all major causes of death, particularly cardiovascular diseases. ⋯ There is no single reason for the health gap, but contributory factors include the increasing prevalence of major risk factors in lifestyles and the environment, and the low efficiency and effectiveness of health care systems. The current situation and short-term prospects are mixed, but the negative trends in mortality and morbidity patterns are likely to continue for some time. While the worst health problems of the transition period in the CCEE/NIS could largely have been avoided, there is no doubt that economizing on health today will exact large costs tomorrow.
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World Health Stat Q · Jan 1993
Natural and man-made disasters: the vulnerability of women-headed households and children without families.
Since 1980, over 2 million people have died as an immediate result of natural and man-made disasters and by 1992, the refugee population registered nearly 16 million people. This article reviews the human impact of disasters as a composite of two elements: the catastrophic event itself and the vulnerability of people. It also examines the specific case of women and children in the current world emergency context. ⋯ Finally, it addresses certain policies and approaches to disaster rehabilitation which effectively mirror and reinforce inherent inequities in the affected society. The article notes that: (i) the largest proportion of disaster victims today arise from civil strife and food crises and that the majority of those killed, wounded and permanently disabled are women and children; and (ii) the ability of any country to respond effectively to disasters depends on the strength of its health and social infrastructure, and its overall developmental status. It concludes by identifying seven areas where concrete measures could be taken to improve the current situation.
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The great hope and promise of post-independence efforts to promote equitable health care in Zimbabwe started with three years of dramatic improvement. Commitment to correcting inequities which were as discriminatory as any country in the world produced rapid extension of health centre infrastructure and the improvement of district hospitals. The major constraint was the entrenched pattern of sophisticated, high-technology health care left by colonial administrators which continued to monopolize resources. ⋯ International agencies also would like to find a way to help reallocate services. There seems to be recognition that little will be accomplished in improving health conditions unless services are provided to those in greatest need. Disparities in maternal care are especially severe and can be improved only by building infrastructure to provide antenatal and perinatal services.(ABSTRACT TRUNCATED AT 250 WORDS)
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India is undergoing an epidemiological transition and is on the threshold of an epidemic of cardiovascular disease. Cause-specific mortality data indicate that cardiovascular disease is already an important contributor to mortality. ⋯ Surveys in urban areas suggest that coronary risk factors are already widespread and that urgent action is needed to prevent a further rise as socioeconomic development proceeds. It is vital to obtain epidemiological data from several regions in order to plan, initiate and monitor public health action.
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Japanese encephalitis (JE) remains endemo-epidemic in several countries in East, South-East and South Asia. The disease has been under control in Japan since the 1970s owing to mass immunization using mouse-brain-derived inactivated vaccine and to reduced vector mosquito populations. The vector density which was once reduced by wide spraying of insecticides in rice fields showed an increasing trend after the 1980s as a result of mosquito resistance. ⋯ In spite of slight antigenic differences among JE virus isolates, JE vaccine produced by a classical Nakayama strain was effective in preventing overt JE in a field study in Thailand. The technology of mouse-brain-derived inactivated JE vaccine production was transferred from Japan to India, Thailand and Viet Nam. The production of JE vaccine in these countries is still on a pilot scale and insufficient for mass-immunization of susceptible target populations.(ABSTRACT TRUNCATED AT 250 WORDS)