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Biomedical subjects

R Feachem

Publications and source records attributed to R Feachem.

14 recordsLinked to original sources
PubMed1994

Health decline in eastern Europe.

Large relative and absolute declines in health status in Central and Eastern Europe since the mid-1960s place the countries of this region at a considerable disadvantage as they strive to compete and participate in the new Europe.

Adult↗
PubMed1984

Home-based oral rehydration therapy in rural Zimbabwe.

A study was carried out in four rural areas of Zimbabwe to assess the acceptability, feasibility and accuracy of sugar-salt solutions and to investigate the action taken during a recalled episode of diarrhoea in a child. Only 5% of respondents gave the child a sugar-salt solution at home during the described illness yet a majority (52%) claimed knowledge of oral rehydration techniques. A great variety of recipes were described; 46% of respondents knew a recipe for a solution containing sugar and salt and 12% were able to describe the standard recipe for sugar-salt solutions. Those who knew a recipe for a sugar-salt solution were asked to prepare a sample for chemical analysis; of those who prepared a sample, 26% prepared a solution having both sucrose and sodium concentrations within the safe and effective ranges. Surprisingly therefore, 12% (26% X 46%) of rural adults were able to prepare a safe and effective oral rehydration solution, despite the fact that there is as yet no concerted programme for the promotion of home-based oral rehydration therapy in Zimbabwe. The standard method of preparation was taught to all respondents who had no previous knowledge of sugar-salt solutions. Recall of the standard method was good; after a period of 11 to 26 days 64% of respondents remembered the correct recipe and 84% prepared a solution having both sucrose and sodium concentrations in the safe and effective ranges. 92% of all households had a teaspoon, sugar and salt and 88% had all the required items: a 750 ml bottle, a teaspoon, sugar and salt. It is concluded that home-based oral rehydration therapy using sugar-salt solutions is an acceptable and feasible strategy for the early management of acute diarrhoea in rural Zimbabwe.

Child↗
PubMed1984

Preparation of sugar-salt solutions.

Correct measurement techniques are essential for the preparation of oral rehydration solutions but dangerous or ineffective solutions may also result from the inherent variability of the method and ingredients. This paper describes an experimental study conducted in Zimbabwe to compare the reliability of three methods for measuring sugar and salt in a 750 ml bottle of water: (i) 6 level teaspoons of sugar and half a level teaspoon of salt, (ii) 3 heaped teaspoons of sugar and half a level teaspoon of salt and (iii) 3 level measures of sugar and salt with a double-ended spoon. The teaspoon and 750 ml bottle methods produced reliable results. Heaped teaspoons of sugar gave more reproducible sucrose concentrations than level teaspoons . The double-ended spoon was not more reliable and gave disquietingly high sodium concentrations with refined salt. Under field conditions the level teaspoon method gave more variable results but still within acceptable limits. It is concluded that a domestic teaspoon and a standard 750 ml bottle can be recommended for the preparation of home-based oral rehydration solutions in rural Zimbabwe.

Fluid Therapy↗
PubMed1984

Perceptions of childhood diarrhoea and its treatment in rural Zimbabwe.

In the course of a study on the acceptability and feasibility of home-based oral rehydration therapy in rural Zimbabwe, information was collected on attitudes and beliefs about diarrhoea and on action taken in response to an episode of diarrhoea in a child. Diarrhoea was found to be a perceived threat at community and family level and numerous possible causes of diarrhoea were described which were assigned to two broad classes: (1) 'physical' causes, such as a polluted environment, diet and teething and (2) 'social and spiritual' causes such as those associated with a depressed fontanelle. These domains were not, however, mutually exclusive; 76% of the described episodes of diarrhoea were attributed to 'physical' causes, 15% to 'social and spiritual' causes and 8% to a combination of both. Reported utilization rates of the formal health services were unexpectedly high. In contrast, we recorded a low demand for indigenous herbalists (n'angas). Home management was common and comprised the administration of indigenous herbal remedies, of sugar and salt solutions, of over-the-counter drugs or of enemas. These remedies were given on their own or alongside the treatment prescribed by a health worker. A number of variables were examined to assess their influence on health-seeking behaviour: perceived cause and severity of the illness, socio-demographic characteristics of the respondent or child and accessibility of the health services.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1979

Seasonal dimensions to rural porverty: analysis and practical implications.

This paper reports on a conference on seasonal dimensions to rural poverty. Presentations included specialised papers on climate, energy balance, vital events, individual tropical diseases, nutrition, rural economy, and women, and also multi-disciplinary case studies of tropical rural areas from the Gambia, Nigeria, Mali, Kenya, Tanzania, India and Bangladesh. While care is needed in generalising, the evidence suggested that for agriculturalists in the tropics, the worst times of year are the wet seasons, typically marked by a concurrence of food shortages, high demands for agricultural work, high exposure to infection especially diarrhoeas, malaria, and skin diseases, loss of body weight, low birth weights, high neonatal mortality, poor child care, malnutrition, sickness and indebtedness. In this season, poor and weak people, especially women, are vulnerable to deprivation and to becoming poorer and weaker. Seasonal analysis is easily left out in rural planning. When applied, it suggests priorities in research, and indicates practical policy measures for health, for the family, for agriculture, and for government planning and administration.

Agriculture↗