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Biomedical subjects

W M Pick

Publications and source records attributed to W M Pick.

13 recordsLinked to original sources

Hypertension in family practice. A study of knowledge, attitudes and practices.

A study was conducted in Cape Town during 1990 to investigate the knowledge, attitudes and practices of 90 family practitioners with regard to hypertension and its management. Hypertension was regarded as an important health problem by 59% while 5% thought that it was not important. Sixty-eight per cent of family practitioners estimated that less than 15% of their patients suffered from hypertension and 78% of family practitioners estimated that more than 70% of their hypertensive patients' blood pressures were controlled. Fifty-five per cent of family practitioners thought it acceptable for a lay person to measure blood pressure and 68% felt that the use of a hypertension register in the practice would assist in the management of hypertension. The information gathered will be of great value in planning intervention strategies and developing hypertension management aids that could assist the family practitioner.

Clinical Competence

A methodology for resource allocation in health care for South Africa. Part IV. Application of South African Health Resource Allocation formula.

The primary concern of this concluding article in a series is the application of the South African Health Resource Allocation (SAHRA) formula proposed in the previous article (SAMJ 1990; 77: 456-459). Target allocations based on this formula are compared with current budgets to estimate the extent of geographical maldistribution of health care resources. Under the present health service structure, the direction of redistribution of these resources should be from the provinces to 'homelands'. A number of refinements to the crude formula, such as the introduction of a more rational regionalisation policy and accounting for the teaching commitments of academic hospitals, are considered and their effects illustrated. Despite data deficiencies and the wide range of possible technical modifications to SAHRA, the concept of basing resource allocation decisions on an internationally applied formula is worthy of public debate.

Education, Medical

Urbanisation and women's health in Khayelitsha. Part I. Demographic and socio-economic profile.

Demographic and socio-economic data and information on migration patterns and urban/rural links was collected from 722 households in the formal housing area and the serviced and the unserviced site areas of Khayelitsha; 659 women and 61 men were interviewed. Thirty-eight per cent of the population were aged under 15 years and 77% under 35 years. There was a predominance of females in the 5-35-year age group. There was a mean of 4.9 persons per household, and 93.5% of sites contained 1 dwelling. Of the 659 female respondents, 7% had received no formal education, 39% had primary school education, and 54% had secondary school education. Unemployment among women was 45%. Domestic service accounted for 66.2% of formal employment. Of all women 86% were unskilled, 71.9% had been born in a 'homeland', and 69.7% had migrated to an urban area before 1985. Ties to the rural areas were strong, particularly in the 'shack' areas. 'New arrivals' to an urban area were young, mostly unemployed, and lived in the worst environmental conditions. In the unserviced 'shack' areas, 47.5% of women had migrated to an urban area in the last 5 years. There are important target areas for a study of the health effects of urbanisation and for possible interventions. This study tends to confirm the 'quadruple' oppression of women in Khayelitsha, on the basis of race, social class and gender and as new arrivals in an urban environment.

Adolescent

Urbanisation and women's health in Khayelitsha. Part II. Health status and use of health services.

A study was conducted among women in Khayelitsha to determine the relationship between urbanisation, health status and use of health services; 722 households were visited, and 659 female respondents provided information on acute and chronic illness for the 3,229 individuals who were members of their households. In addition, they provided information concerning their reproductive health, AIDS awareness, knowledge of cervical smears and use and knowledge of health services. Acute illness was reported for 4.3% of the study population, the commonest complaints being diarrhoea, abdominal pain and upper respiratory infections; 4.4% reported chronic illness, the commonest complaints being hypertension and tuberculosis; 16.2% of women reported gynaecological illness; 86% had of heard of AIDS (although their knowledge of transmission and prevention was poor); and 45% had heard of cervical smears. Patterns of illness and knowledge and use of health services vary in the different areas of residence of Khayelitsha. This appears to be related to urbanisation, age, and environmental and socio-economic factors.

Black or African American

The epidemiology of hypertension in family practice in Cape Town.

A prevalence study of hypertension in 8 family practices in low socio-economic areas of Cape Town examined 1,046 patients over the age of 15 years. The crude prevalence rate of hypertension was 20.26%. There was no significant sex difference. Systolic pressure, diastolic pressure and hypertensive status increased with age and body mass index (BMI). There were complex relationships with regard to sex in that the female sex was predictive of hypertensive status after the age of 45 years unexplained by differences in BMI. After adjusting for age, BMI and sex differences, widowhood, poor education, obesity, a family history of hypertension or stroke and a past history of hypertension were significant predictors of hypertensive status. Smoking status, occupational social class or property ownership were not predictive. Fifty-one per cent of hypertensive subjects were treated. Of those receiving treatment, 30% were controlled resulting in a control prevalence of only 18%. Younger male subjects were better controlled by treatment. A strong need for improved diagnosis and treatment of hypertension in family practice exists in this region.

Adolescent

A methodology for resource allocation in health care for South Africa. Part II. The British experience and its relevance to South Africa.

This second article in the series on resource allocation in health care, argues for a formula-based method of resource allocation in South Africa. The model employed in England since 1976 and its application in a number of developed and developing countries is reviewed. The international experience is related to South African conditions and the principal elements necessary for a formula to achieve greater spatial equity in South African health-resource distribution are discussed.

Delivery of Health Care

A methodology for resource allocation in health care for South Africa. Part III. A South African health resource allocation formula.

A formula to calculate the proportion of the public sector budget that should be allocated to various geographical regions of South Africa is described. The formula is broadly classified into curative and preventive components. Using data that are routinely available, indices of need are calculated for each of these components. It is concluded that resource allocation on a macro level should closely approximate regional population distribution if cross-border flow of patients and additional teaching-hospital expenditure are ignored.

Age Factors

A methodology for resource allocation in health care for South Africa. Part I. Rationale and prerequisites.

A strategy for the equitable allocation of health care resources is needed in South Africa. The existing health administrative structures are obstacles to achieving this goal. An attempt is made to describe a framework in which the prerequisites for the equitable allocation of resources are a major restructuring of health services into a number of regional health authorities in a unified health service, and to establish a formula which is adapted from the RAWP (Resource Allocation Working Party) model used in the UK.

Health Care Rationing

Community participation in the Mamre Community Health Project.

From the outset, community participation has been a working principle of the Mamre Community Health Project. The health planning approach was the predominant one used in Mamre. Attempts at improving community participation include the involvement of a steering committee elected by community members, the use of local people as interviewers and the feedback of results to the community in an accessible way. The process of negotiation of entry into the community was concluded. While consent and passive participation of the community were achieved, active participation remains a challenge for the future. Means of realistically evaluating community participation need to be developed.

Community Health Services

Rectal myiasis.

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Child