Biomedical subjects
Publications and source records attributed to W Bichmann.
A description is given of the initial stages in the development of a methodology for assessing community participation in health schemes. A study in Nepal indicates that the approach adopted will be useful to planners who wish to evaluate involvement in primary care programmes.
This paper considers the problems of finding measurements for the two major principles of primary health care (PHC), equity and participation. Although both are of equal importance, the authors concentrate on the assessment of participation. A methodology is put forward to define indicators for participation in health care programmes as how wide participation is on a continuum developed for each of the five factors which influence community participation. These factors are: needs assessment leadership, organisation, resource mobilisation and management. By plotting a mark on a continuum which is defined as wide and narrow at the extremes and is connected with all other marks in a spoke arrangement, it is possible to describe a baseline for participation in any specific health programme. This baseline can be used to compare the same programme at a different point in time, to compare observations by different evaluators, and/or to compare perceptions of different participants in the same programmes. A case study provides an example of how the indicators might be used. These indicators focus on the breadth of participation and not its potential social impact, an area which is recognised to be critical for future research.
The authors report on a case of multiple vitelliform retinal cysts which were observed by chance during an examination for an expert opinion on a bulbar contusion. It is shown that these cysts are hard to recognize by simple ophthalmoscopy, but may be visualized by fluorescein angiography in the form of bright circular areas, sometimes differently colored. The developmental mechanism is illustrated with histologic pictures.
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