Articles: health.
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Review Comparative Study
Postpartum tubal sterilisation: an international perspective on some programmatic issues.
The demand for postpartum sterilisation (performed within 42 days after delivery), is increasing both in developed and developing countries. The incidence of regret after postpartum sterilisation is important, but it could be minimised by carefully screening risk factors. Using trained paramedical personnel to perform postpartum sterilisation via minilaparotomy where physicians are in short supply appears to be safe and acceptable, under close medical supervision. Including postpartum sterilisation information in the antenatal counselling services effectively strengthens postpartum services and simultaneously helps to minimise subsequent regret.
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We report here on a child who over a period of 8 years was admitted several times to hospitals in different states of Nigeria based on fictitious illnesses described by his mother. The child had various unnecessary, expensive and invasive investigations followed by treatment with harmful drugs. The evolution of this case of Munchausen syndrome by proxy is described in order to alert paediatricians in developing countries to a problem which is described frequently in more affluent societies. We believe this is the first such case to be recorded in West Africa.
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Surveillance is the foundation of public health practice. This review examines the experience of surveillance in the Expanded Programme on Immunization (EPI). Surveillance systems include routine reporting, sentinel surveillance, and community-based reporting. ⋯ The surveillance of vaccine-preventable diseases has evolved as programmes mature, to monitor progress towards disease control targets. The establishment of goals to reduce measles cases by 90%, eliminate neonatal tetanus, and eradicate poliomyelitis has put increased emphasis on the need for effective disease surveillance. This opportunity should be taken to promote strengthening of national routine systems for disease surveillance, to make them effective instruments for prevention and control of diseases of public health importance.
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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.