Articles: health.
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Women in rural areas are highly dependent on public clinics for family planning services, yet little information has been collected on rural family planning providers, especially on their funding and operation. ⋯ Family planning clinics in rural Washington State offer an important but limited number of services. Many rural areas have no local family planning clinic. Given these clinics' reliance on federal and state funding, decreased public support might seriously impair family planning provision in rural areas.
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To qualitatively assess the referral system at district level from the consumers' point of view and assess implications it had on efficiency and effectiveness of service delivery. ⋯ In general, the community did not fully comprehend the purposes and intentions of the new user fees policy of January 1994 which was meant to rationalise the referral system. Generally, communities are seldom consulted in time to ensure effective policy implementation and realisation of the intended impact. Impressions generated on the impact of the problem of the referral system on resource use at hospital level show that it has been considerable, although this study did not quantify it. Unnecessary overloading of referral centres negatively affected the care of referral cases, which actually required hospital care, due to competition with primary care cases.
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Pediatric pulmonology · Apr 1998
Reproductive health in males with cystic fibrosis: knowledge, attitudes, and experiences of patients and parents.
Males with cystic fibrosis (CF) are generally infertile as a result of aberrant development of Wolffian duct derivitives. The personal significance of this and related reproductive and sexual health (RSH) issues is unknown. We set out to describe the knowledge, attitudes, and experiences regarding RSH in a group of adolescent and adult males with CF, as well as the knowledge and attitudes of parents. ⋯ We conclude that the majority of males with CF know of likely infertility. The significance of this knowledge changes with time. Poor knowledge and confusion surround a range of RSH issues in males with CF.
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WHO's activities at country level have earned the organisation both criticism and praise. The organisation's technical publications are esteemed as authoritative guidelines for disease control. Successful disease-control programmes and contributions to health research have heightened WHO's reputation. ⋯ But WHO has been criticised for not adapting rapidly and logically to changes in the health field. With increasing national capacity in the more advanced developing countries, and with the involvement of new participants in the health sphere, the organisation needs to reassess its role at country level. My recommendation is that WHO improves its analytical capacity so that its programmes take into consideration the health needs of the country, its national capacity, and the contributions from other external agencies.