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Biomedical subjects

F M Mburu

Publications and source records attributed to F M Mburu.

At least 19 recordsLinked to original sources
PubMed1994

Health delivery standards: vested interests in health planning.

The thread of this paper is that vested interests prevail consistently in the formulation of health policy and provision of health services. Several African countries illustrate how the health care standard becomes an end in itself, however ineffective it becomes as population and needs change. Policy is not an exclusive prerogative of governments. Industry of all sorts, non-governmental organizations (NGOs) and development agencies use policies to determine, guide and shape investments and, in the case of the private sector, prevail favourably in competition. With a few exceptions, planners plan to depict and alter a particular situation, to improve conditions according to a particular mode, ideology or belief. The planner, like the policy maker, assumes that certain changes will occur if certain decisions are made or actions are taken. In reality, however, policy makers and planners are seldom satisfied with the status quo. The policy maker decides on the basis of available information, albeit incomplete or inconclusive, and believes one option is better than another or that it will achieve the desired goal optimally and at least cost. To formulate policy is to choose a course of action and to plan is to pursue a particular interest. However implicitly, vested interests are entrenched in every policy action. There seems to be four main, but related reasons for any specific health policy: availability of adequate health care; equity of access; cost; and effectiveness/relevance of the system under the prevailing technology. While concerns differ, sometimes quite widely, concern for an effective health system is always paramount. Less than two decades ago, African countries had more robust economies than they have today.(ABSTRACT TRUNCATED AT 250 WORDS)

Delivery of Health Care↗
PubMed1989

Non-government organizations in the health field: collaboration, integration and contrasting aims in Africa.

How and why non-government agencies operate their many health projects in less developed countries deserves more than causal mention. Among salient factors are sources and magnitude of funding, size and duration of projects, the philosophy, operation and performance of non-government organizations. Most NGOs have many strengths, vantage points and ability to initiate viable health programmes. Their strengths, however, account for most of their shortcomings such as autonomy, lack of linkages with established health systems and policy isolation. Can the gaps be bridged without loss to the beneficiary country and the NGO and, if so, how?

Africa↗
PubMed1989

Whither community-based health care?

This paper identifies implications for community-based health care (CBHC). Sustainability of CBHC depends on effective community involvement, power sharing, adequate resources and, above all else careful planning with the community expected to benefit from CBHC.

Community Health Services↗
PubMed1987

Changes in sources of treatment occurring after inception of a community-based malaria control programme in Saradidi, Kenya.

To determine the changes in source of antimalarial treatment and perceptions about malaria after the initiation of a community-based malaria control programme in Saradidi, Kenya, two identical surveys were carried out; one in March 1982 (before the programme began in May 1982) and the other in December 1984. Three areas were involved: areas A and B had antimalarial treatment provided by village health helpers (VHH's) and area C had VHH's who did not provide treatment. Two groups of randomly selected women age 15 to 59 years were interviewed: 45 in survey 1 and 92 in survey 2. A decided change in the source of malaria treatment was observed. In the first survey, 52.9% of the respondents from areas A and B combined purchased antimalarial medicine from shops; other sources were government health facilities, mission clinics, and the Saradidi community clinic. By the second survey, 85.2% of the respondents in areas A and B obtained treatment from the VHH's; no significant change occurred in area C. In both surveys the leading reasons given for people purchasing drugs from shops was that the distance to health facilities was great, that no transport was available and that shops were open when emergencies occurred. The shopkeeper frequently advised which drug to take and the dosage as well as selling the drugs. For family illnesses of unknown aetiology most people (82.2% in survey 1 and 97.8%, in survey 2) went to a hospital or clinic. These results demonstrate that the malaria control programme in Saradidi has influenced both the source of antimalarials and the attitudes people have about malaria. In Saradidi, Kenya people chose to obtain antimalarial treatment and advice from community health workers.

Adolescent↗
PubMed1986

Image--reality cleavage in development goals.

Within a relatively short time since its inception a lot has been said on the concept of 'Health for All' (HFA). Its meaning and implications have been explored from various angles. Some have praised the idea as the very one we have been waiting for to improve health more effectively. Others have been sceptical. A few, particularly the hard core clinicians and laboratory-oriented health professionals, have been cynical. The overall outcome from the different viewpoints has been almost irreconcilable contradiction. HFA ideas will definitely work, say the proponents; if only we can objectively analyse the meaning and import of HFA, we could select what is feasible and reject the rest, advise the sceptics; HFA, insist the conservative and radical sceptics, is a terminological hotch-potch loaded with so many inexactitudes that the idea lacks direction, feasibility and acceptability even among the ranks of the majority of its proponents. Consequently, planning for HFA has been rather lacklustre in most countries. Failure is often hidden in obscurantist masses of data manipulated to support whatever position is sought to suit the desired situation. Curiously, while there is no dearth of experts on the meaning of data, the reliability of some data leaves much to be desired, their sources and method of collection being as peculiar as the results they imply. But, if the source is unreliable, so must be the outcome. What, then, is HFA and what are the needs to be met?

Africa↗
PubMed1986

The African social periphery.

There are special population groupings in Africa which constitute a social periphery of great magnitude. The groups include women and children, the urban and rural poor, and a youthful labour force that is relatively uneducated. The critical issues they face include ever-increasing food shortage, decreasing employment opportunities and political instability which further reduces the effectiveness of government. While solutions are not easy to find, they require urgent critical assessment by policy makers and planners.

Adolescent↗
PubMed1983

Health systems as defences against the consequences of poverty: equity in health as social justice.

The main development problems in the Third World are known to be gross socioeconomic inequality, widespread poor health status accompanied by high fertility and infant mortality rates, low life expectancy, mass illiteracy and mass poverty. In most of these countries governments invest a great deal of scarce resources toward the consequences of poverty rather than it causes. The paucity of resources for such social services is exacerbated by continuously increasing demands and needs which have to be satisfied. Unmet needs tend to cause apathy in the population. For purposes of controlling poverty and its consequences, these must be clearly formulated and relevant policies, a commitment to implement such policies, adequate administrative capacity and reasonably adequate resources. In the case of the health services system, the same requirements apply. Above all, the health system has to be directed toward the greatest needs of the population. This must involve policy makers, implementors and the consumer community. This paper argues that health systems cannot be an effective weapon against the consequences of poverty unless the above kinds of policy exist and are implemented.

Africa↗
PubMed1983

Ocular needs in Africa: increasing priorities and shrinking resources.

Current demands for ophthalmic treatment services in Africa far outstrip available resources, especially in terms of ophthalmic surgeons. With a few exceptions, the gross national product per capita in African countries is less than US $500. Even in those petroleum economies where the figure is considerably higher, the wealth is grossly inequitably distributed. In a continent whose population is expected to double within 20 years, this means that the ratio of trained health worker to population is expected to become much greater rapidly. The money needed to expand the corps of specially trained health workers at a rate matching the expected population growth rate is non-existent. About 1% of the African population is blind. The three major causes are cataract, trachoma and glaucoma. These involve specific age groups of the population. Cataract, which causes roughly 40% of all blindness, mostly affects the over-60s. This group comprises 5% of the population. Glaucoma occurs mostly over the age of 40, i.e. in about 20% of the population. The trachoma 'reservoir', from which chronic re-infections arise, is the under-15 group, an alarming 42% of the population. The prevalence of trachoma is inversely related to access to safe water, a commodity generally available to less than half of the people in Africa, and especially limited in rural areas. Finally, nutritional blindness and its associated high-mortality protein energy malnutrition (PEM) affects the under-five segment, about 18% of the population.(ABSTRACT TRUNCATED AT 250 WORDS)

Africa↗
PubMed1983

Prevalence and causes of vision loss in southern Sudan.

Blindness in Southern Sudan is thought to be highly prevalent due to the high prevalence of onchocerciasis and trachoma. In addition, socioeconomic development in the area has been low and growth slow. Communities in the South have not changed much having been unaffected by modern institutions more prevalent in the North. Traditional methods of farming, fishing and pastoralism still persist. However, even these may be hampered by the large scale presence of blackfly and trachoma. This paper describes one approach to define the prevalence and causes of vision loss in Southern Sudan.

Blindness↗