Articles: health.
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Thailand's health care system incorporates the private and public sectors. The government regulates health care through a system of capping, which protects its interests while providing a climate for competition. As a result, the private sector has developed and implemented some interesting concepts in health care as it turned to prevention, hospital care alternatives, neighbourhood-based ambulatory care and home care. The author suggests that Canada could benefit by examining some of Thailand's innovations.
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Prior to 1989, Krabi and Satun, two neighbouring provinces with similar socioeconomic background and health service coverage, had the highest reported incidence rates of neonatal tetanus in Thailand (3 per 1000 livebirths). A control programme was conducted between 1989 and 1991. The objective of this study was to examine changes in prevalence of risk factors among the population and changes in incidence rates of this disease due to this programme. ⋯ From 1989 to 1991, in Krabi Province, the coverage of at least two doses of tetanus toxoid injections at any time prior to delivery, delivery by trained health personnel, acceptable sterile technique for umbilical cord cutting and correct method of dressing the umbilical stump rose from 70 to 88%, 55-80% cent, 80-94% and 40-74%, respectively. Reduction in the incidence rate of neonatal tetanus was achieved by strengthening of routine health services with or without additional mass immunization. Considering that the coverage of immunization has not yet been completed and the prevalence rates of different risk factors are still high, further attempts to improve the problem of neonatal tetanus are necessary.
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The purpose of this study was to compare reasons for choosing to breastfeed, timing of the infant feeding decision, and intended duration of breastfeeding between adolescent and adult mothers. The study population consisted of primiparous teens and adults who were matched by ethnicity, and interviewed within 48 hours postpartum at the University of California, San Diego Medical Center from August to December, 1989. Of the 48 women in each age group, there were 40 Hispanics, 5 non-Hispanic whites, 2 blacks, and 1 Southeast Asian. ⋯ There was no difference in intended duration of breastfeeding between these two groups: the majority of women planned to breastfeed for less than 26 weeks. Early introduction of infant feeding education may serve to increase the adolescent's knowledge base from which to make the decision to breastfeed. Even though the adolescents intended to breastfeed for as long as the adults, they may benefit from increased exposure to prenatal care and childbirth classes as well as from a supportive school or work environment in order to achieve success in breastfeeding.