Health and population; perspectives and issues最新文献

Government of India have prescribed duration, curriculum and trainers for training of PHC field staff under multipurpose workers' scheme. The extent of implementation was studied in three States. Quality of training was also observed and its impact on knowledge and understanding was determined by comparing pre- and post-test scores on different subject areas. Centralised strategy for class room training with HFWTC as the venue was found to offer several advantages. By and large, Government of India's prescribed curriculum had been followed. Deviation had taken place mostly in the type of trainers. Topics and their sequence were well covered. There was, however, little use of training techniques to promote understanding and participation. In particular, there was lack of teaching aids at PHC level class room. Male field staff showed greatest need and profitted most from the training. Knowledge of maternal and child health and family welfare was least in both male and female staff before and after the training. Administrative factors affecting MO of PHCs as trainers were also determined. This is second in the series of papers based on the project findings.

Determination of quantity, quality and characteristics of the wastes of two hospitals located in the same sector of a class B city was undertaken to review the present dumping method of disposal. On an average 1,424.71 and 224.6 kgs. of five types of wastes as per the moisture content were found daily for seven days in these two hospitals of 1000 general beds, and 600 long stay beds for chest tuberculosis and other Cardiothoracic diseases respectively. The wastes of first hospital had higher combustibility due to its sprawling nature and activities for general patients than that of the second multistoreyed hospital treating special cases. A combustibility analysis of hospital wastes would help to decide whether to adopt incineration for disposal.

The philosophy and aims of a health care scheme in Igbo-Ora, Nigeria, are outlined. Some of the problems related to creating a data base from which work can proceed are set out and discussed. Social factors are mentioned, and attention is drawn to the need for seeing health problems against general settings specific to a given area rather than measuring upto some abstract or "scientific" standards. The uncharted ground in many Third World practices make this particularly important.

"Reaching the Deprived Child" is India's theme for the Year of the Child. This paper describes the recording system employed in the Community Health Programme of Christian Medical College, Ludhiana and how it enables us to reach not only deprived children, but those in danger of deprivation, the majority being the children of the socioeconomically underprivileged. Many are nutritionally normal at 12 months but 57 per cent of the males and 75 per cent of the females suffer from malnutrition in the 2nd year, 50 per cent of females having severe malnutrition. The etiology, discerned from a study of the deprived, allowed a preventive approach to be designed for those at risk. Intensive nutrition education is given in the homes, commencing as each baby reaches 5 months, and mothers are taught to feed them on suitable modifications of the food available in Punjab homes. The results in respect of 123 babies who had a minimum of 6 months of this care, are described. Complete compliance was achieved in 82 per cent and in the rest partial compliance was achieved. The nutritional status of these infants, compared with a control group, improved greatly, especially in females in whom the prevalence of normal nutrition rose from 26 to 61 per cent and that of severe malnutrition fell from 50 to 17 per cent. The success of this approach depends on an accurate knowledge of the community since this allows priorities to be selected with clarity and maximum effort to be expanded upon those in greatest need.

The paper analyses the existing constraints in the delivery of adequate health services to children. A strategy for containing the infant mortality due to neonatal causes, diarrhoeal diseases and respiratory infections is presented: suggestions are given for better training of manpower for child health services, continuous supply of drugs and equipment and adoption of the "at risk" approach for identification of children likely to die, without intervention.

The study concerns the problem of low birth weight as seen in a prospectively studied cohort from a South Delhi urban community covering 23,700 families and 1,19,799 population over a four year period from 1969-73. The incidence of low birth weight was 22.9 per cent of which 2.7 per cent had a birth weight of 2000 gms. or less and 20.2 per cent had a birth weight 2001-2500 gms. Maternal height of 140 cms or less and pregravid weight of 35 kg or less were associated with the occurrence of low birth weight infant. The mortality was related inversely to birth weight and the gestation affected the outcome directly. The mortality rates declined sharply in infants of birth weight 2001-2500 gms but was still high as compared to infants of birth weight more than 2.5 kg. The later physical growth was affected by the initial birth weight. The study was conducted under the research project 01-658-2 funded by the National Centre for Health Statistics, 3700 East West Highway, Hyattsville, Maryland-20782, U.S.A.

The Expanded Programme of Immunisation for Children (EPI) operates as part of the maternal and child health programme and budgeted under it. It has been assured that there shall be no constraints of finances for it. This programme will become the touchstone to prove the concern and commitment of the medical and health administrators for the cause of child health in the country. This paper deals with the background of the EPI, recommended schedule of Immunisation and Programme for the future.

The author analyses the factors responsible for delayed hospitalisation of children which ultimately accounts for high rate of mortality. The problem becomes significant as 50 per cent deaths of children in hospital occur within first 24 hours of admission. The experiences included in this paper are based on personal observations and studies conducted by B. K. Shrimali at Smt. Patel Paediatric Centre, Government Medical College, Jabalpur (M.P.).

Four hundred and thirty prospective nursing graduates from ten schools and five colleges in India were studied to identify factors related to their preferences for work in urban or rural areas. Seventy per cent expressed a preference for urban work. Significant factors related to rural preferences were: religion and background (rural or urban); type of educational institution (government or non-government); and living in a rural setting during community nursing experience. Of the personal, professional and socio-cultural factors related to rural work preference, the most significant were: accomodation, sanitation and safe water; job availability for spouse, security, and school for children. Of the personal and professional factors, the most important were: continuing education opportunities, job satisfaction, and intellectual stimulation.