Articles: health.
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Bull. World Health Organ. · Jan 1997
Health expectancy calculations: a novel approach to studying population health in Bulgaria.
The measurement of life expectancy in terms of either good or poor health is a novel approach to studying the health of the population in Bulgaria. The pilot study reported here-carried out among people aged > or = 60 years in a middle-sized Bulgarian town-was designed to obtain information on the years of functional restrictions expected among the elderly. In accordance with the answers to a series of questions (recommended by WHO), subjects were categorized as disabled, handicapped, or having different states of perceived health. ⋯ At all ages, the proportion of life in a condition free of disability, free of handicap, or in perceived good health is substantially lower for women than for men. Women may expect to live longer, but a greater proportion of their life will be spent in poor health. The approach presented here for measuring the health status of the elderly may be helpful as an aid to planning medical and social care and for the development of public health policies.
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Bull. World Health Organ. · Jan 1997
Multicenter Study Comparative StudyPerformance of health workers after training in integrated management of childhood illness in Gondar, Ethiopia.
The performance of six primary health workers was evaluated after following a 9-day training course on integrated management of childhood illness (IMCI). The participants were selected from three primary health centres in the Gondar District, Ethiopia, and the course was focused on assessment, classification, and treatment of sick children (aged 2 months to 5 years) and on counselling of their mothers. Immediately following this training, a 3-week study was conducted in the primary health centres to determine how well these workers performed in assessing, classifying and treating the children and in counselling the mothers. ⋯ The mother's counselling card, which summarized recommendations on feeding and home fluids, and advice on when to return, was widely used to aid communication. The time taken to perform the complete management of children did not change significantly (20 to 19 minutes) during the study. Lessons from our findings have been incorporated into an improved version of the IMCI charts.
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Bull. World Health Organ. · Jan 1997
Comparative StudyThe WHO Global Programme for Vaccines and Immunization Vaccine Trial Registry.
In 1995, the WHO Global Programme for Vaccines and Immunization established a Vaccine Trial Registry. As of September 1996, this registry included 50 WHO-supported vaccine trials, of which 25 (50%) were completed studies. ⋯ Among the 25 completed trials, outcomes measured were immune response (24 trials), adverse reactions (13 trials), morbidity (4 trials), and mortality (1 trial). WHO's contributions to these studies include direct funding, assistance with study design, site visits, data analysis, vaccine procurement, and vaccine potency testing.
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India has an excellent infrastructural layout for the delivery of MCH services in the community through a network of subcenters, primary health centers, community health centers, district hospitals, state medical college hospitals, and other hospitals in the public and private sectors. However, the health pyramid does not function effectively because of limited resources, communication delays, a lack of commitment on the part of health professionals, and, above all, a lack of managerial skills, supervision, and political will. The allocation of financial resources for the delivery of health care continues to be meager. ⋯ The RCH program, to be launched shortly, aims at effective utilization of these facilities to ensure delivery of integrated services of assured quality through decentralized planning. Simultaneously, as a result of the ongoing economic liberalization, the MCH care in the private sector will also expand rapidly. Indeed, India is on the threshold of an extraordinary improvement in the status of its neonatal-perinatal health.
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Bull. World Health Organ. · Jan 1997
Assessment of potential indicators for protein-energy malnutrition in the algorithm for integrated management of childhood illness.
Potential indicators were assessed for the two classifications of protein-energy malnutrition in the guidelines for integrated management of childhood illness: severe malnutrition, which requires immediate referral to hospital, and very low weight, which calls for feeding assessment, nutritional counselling and follow-up. Children aged < 2 years require feeding assessment and counselling as a preventive intervention. For severe malnutrition, we examined 1202 children admitted to a Kenyan hospital for any association of the indicators with mortality within one month. ⋯ Among ill children in Kenya, a threshold WFA Z-score of < -3 had a sensitivity of 89-100% to detect children with WFH Z-scores of < -3, and, with an identification rate of 9%, would avoid overburdening the clinics. Potential modifications include use of a more restrictive cut-off in countries with high rates of stunting, or the elimination of the WFA screen in order to concentrate efforts on intervention for all children below the 2-year age cut-off. Key issues in every country include the capacity to provide counselling for many children and linkage to nutritional improvement programmes in the community.