Health and population; perspectives and issues最新文献

This paper attempts to highlight some of the presently accepted models of health, behaviour and their usage in explaining illness, sickness and utilisation behaviour. The limitations of each of the model have also been described. Finally an attempt has been made to visualise the applicability of such models on Indian health system. A viable model already tested has been proposed to assess the social patterns of seeking medical care in rural setting in India.

A survey of perceived morbidity was carried out in rural population in eight villages and four wards of Saoner town, covering a total population of 8,876. The nature of illness was assessed by weekly visits to the families. History regarding treatment taken for disease and its source was taken. The overall incidence of perceived morbidity was 176.35 spells of sickness per 1000 population per month. Health care agency was contacted for 36.7 per cent spells of sickness. Utilisation of health services was found to be affected significantly by factors like age (chi 2 = 138.36), literacy (chi 2 = 14.123), type of occupation (chi 2 = 433.74), nature of illness (chi 2 = 83.578) and accessibility of health services. A health behaviour model of the population has also been discussed in this paper.

In this paper, the author deals with the financial planning and control of health programmes in India. The techniques of cost-effectiveness analysis and of performance budgeting are highly useful aids to management for implementation of monitoring and review of performance of the programmes are also essential for gauging the progress.

This paper deals with the study of assessment of hospital services and patient reactions carried out amongst 473 respondents, both in-door (3 wards) and out-door patients in M.L.B. Medical College Hospital, Jhansi (Uttar Pradesh). The patients were from three wards medical, surgical and gynaecological wards and consisted of 373 discharged and 100 out-door patients.

Are organisational climates in private hospitals compared to public hospitals, more favourable? To assess the differences, motivational orientations, perceived satisfaction with intrinsic aspects of the job, professional commitment orientations and perceived organisational climates by the medical professionals, senior administrative and professional nursing personnel are compared. All the groups in the public hospital tended to be higher in motivational orientations. On the other hand, all the groups in private hospital showed higher satisfaction with intrinsic aspects of the job, professional commitment orientations, and perceived favourableness of the organisational climate. The differences were found to be not significant.

For development of a people-oriented hospital and primary care facilities in its peripheral health maintenance services, a rethinking of the planning concepts of the roles, attributes and various components, viz. user, provider, institutional, social and financial control is required. The emphasis in discussion of the various elements of the planning process is on need-orientation for the rural disadvantaged and availability of limited resources.

The medical systems which most of the developing countries have, are ad hoc adoptions inherited from their colonial masters and have met with little success in making health planning as part of their national planning. Very few countries have been able to overcome the resistance of the medical profession and the bureaucratic inertia which is a major obstacle in the transformation of this system to a broad based social service and integrating it with the process of socio-economic development planning. The adoption of this system by developing countries is a typical example of technological misfit. A cheap and labour intensive model for developing countries shall be a proper solution for the development of a health care delivery system for the masses. A solution to this problem is a mix or hybrid of the traditional and modern medicines which very recently have been exploited both in India and China. How far India and China have been successful and what is needed to be done is the subject matter of this paper.

This study reports findings on the time spent by CGHS medical officers per patient in different medical care activities for 2,115 patients, as obtained by time study technique. This study was conducted during the year 1976-77. The average observed time spent by the medical officer per patient was found to be 117.15 seconds per patient. The medical officers elicited only main complaints without asking past and family history in 84.44 per cent of patients and the average time spent on history taking was 42 seconds per patient which also included examination of identify card, recording of name, age and sex of the patients. Physical examinations were conducted in only 23.88 per cent of patients and the time spent per patient was 45.93 seconds. The advice for investigations was imparted in 2.60 per cent of patients, though the facilities for routine laboratory examinations were available in the dispensaries. Advice to the patient regarding dietary instructions and general advice was exclusively given in only 5.20 per cent of cases whereas the family planning/health education advice to the patients was given only in 0.76 per cent of patients. The medical officers are aware of the inadequate quality of medical care provided to the beneficiaries and they felt they should at least spend 6.83 minutes for an old patient and 12.42 minutes for the new patient. Probably they are not able to do so because of long queues in the dispensaries during peak hours. Hence, to improve the overall medical care and provide comprehensive care to the beneficiaries it is suggested that the medical officers can be given certain beneficiary population and made responsible to them.

In this paper, the author stressed the needs for a central arrangement for acquisition, exchange and dissemination of scientific information in the field of health and family welfare so as to increase the efficiency and effectiveness of planning, administration and evaluation of health and family planning programmes and also to carry out research when needed. The proposed arrangement in the form of a documentation centre must collect information on health care systems as their main functions so that the information and documentational needs for the education and training of health personnel are rationally developed in the context of present and future health needs and demands.