Feeding of workers in developing countries.
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Developing Countries↗
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Injury surveillance in developing countries.
In both developed and developing countries, injuries have a substantial effect on the public's health and on quality of life. Although epidemiologic data regarding the occurrence of injuries in developing countries are limited, recent studies have documented substantial injury-related morbidity and mortality in some of these countries. For example, recent studies in rural Papua New Guinea showed that injuries are the leading cause of death for persons ages 15-44 years. Similarly, injuries are the leading cause of hospitalization in Indonesia and Egypt. Surveillance of injuries is necessary in order for public health practitioners and planners in developing countries to direct and allocate scarce resources appropriately.
Adolescent↗
Provision of medicines in a developing country.
In many developing countries the money spent on drugs could often be used more effectively to prevent disease. A large proportion of the drug budget of one developing country is spent on expensive proprietary preparations for use mainly in the larger hospitals, draining resources from health care in rural areas. A major factor in determining the country's expenditure on drugs is the promotional activities of pharmaceutical companies; the number of drug company representatives in the country is proportionately five times that in Britain. Many drugs are promoted for diseases for which they are not indicated and in which their use may be hazardous, and information on side-effects and contraindications is inadequate. Information supplied by drug firms to health workers in different countries must be standardised and the purchase and use of drugs in Third-World countries made more appropriate to their needs.
Costs and Cost Analysis↗
Assessment of national family planning programs in developing countries.
Today, 34 developing countries have policies and programs to lower fertility, and an additional 32 countries provide family planning services for health and humanitarian reasons. Specific causal relationships and linkages between social and economic development, family planning programs, and fertility levels and changes remain mostly unclear at this point. Based on percent acceptors, percent users, and changes in fertility rates (the most commonly used measures to evaluate family planning program accomplishments), however, the performance of programs on the whole has been moderately encouraging.
Abortion, Legal↗
Women's access to health care in developing countries.
Women in developing countries are frequently confronted with a myriad of socio-cultural factors which negatively impinge upon physical well-being and accessibility to appropriate health care services. Institutional, economic, and educational barriers effect and lowers their standard of living when compared to their male counterparts. Women must become agents of change to improve their situation. Factors such as access to income, legal rights, social status, and education may prove far more important in determining women's access to health care than technology distribution and governmental strategies.
Cross-Cultural Comparison↗
The need for quality control in the developing countries.
In the developing countries there is a need for greater activity in the quality control of vaccines used in immunization programmes. The establishment of a quality control facility can give assistance not only in the checking of vaccines at the time of release, but also in monitoring the efficacy of the cold chain. Furthermore, the antibody responses of the local child population to the vaccines can be measured. Quality control should be established before vaccine manufacturer, therefore, and the economics of importing vaccine in the bulk concentrated form with dilution, blending and filling locally is worthy of consideration.
Antibodies↗
The role of drug information centres for improving patient care in Pakistan and other developing countries.
Relevant and uptodate information about drugs in common use is either unavailable or scarce, in Pakistan and other developing countries. Developed countries inspite of all the facilities available for learning have recognised the limitation of human memory. Drug information centres have therefore been established for repeated reminder and continued education for the practicing doctors in prescribing drugs and early recognition of adverse reactions to them. The proposal for establishing such drug information centres in Pakistan and other developing countries for further improving the patient care and early reporting of adverse reaction to drugs in this paper is based on the encouraging response to and beneficial experience by such centres in the western world. There is every reason that it will succeed in improving the health of the people of Pakistan.
Developing Countries↗
Specialist training and medical research in developing countries of tropical Africa: a case for the establishment of postgraduate medical schools.
Developing countries like developed ones need highly skilled medical personnel, referred to as 'specialists'. In the case of developing countries, the training of these specialists abroad is expensive to the sponsoring governments, imposes a lot of hardship on the doctors and, above all, the course-content of such training takes little or no cognizance of the environment in which these doctors would later practise. The developing countries also cannot afford the loss of years in valuable services which the training abroad entails. Attempts are now being made to train specialists wholly or partly at home, in some developing countries. The approach is still not much divorced from what obtains in Britain and North America, that is, one of being trained on the job, with the onus for self-education being placed on the prospective students. Such students in most developing countries of tropical Africa have little or no facilities for further education outside their places of work. It is proposed that purpose-designed postgraduate medical schools may provide a temporary solution to specialist training in developing countries of tropical Africa. Such schools would in addition provide highly skilled medical service as well as obviate the need and the expense for the setting up of government sponsored medical research and training institutes.
Africa, Western↗
[Basic principles of the dynamics of mortality and average life expectancy in various economically developed capitalistic countries and developing countries].
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Adult↗
Potential contribution of primary-school teachers to the health of a developing country.
Like many other developing countries, Kenya gives higher priority to primary education than to health services. Thus, in rural areas primary schools are evenly distributed, well attended, and staffed by well-qualified teachers whereas health centres are thinly scattered, inaccessible to many, and staffed largely by people of low educational attainment. The public-health knowledge of school teachers exceeds that of many health workers. It is suggested that teachers of health science, in particular, represent a valuable resource for preventive and promotive medicine which can be exploited at little cost.
Allied Health Personnel↗
Ergonomics for occupational hygienists in developing countries with examples from Sri Lanka.
Occupational health problems in developing countries, especially those situated in the tropical zone, are difficult to define. The conditions are more adverse in unorganized small-scale industries. The application of ergonomic principles in the practice of occupational health in developing countries must be subject to all aspects of community health and impact of industrialization as well. Ergonomics offers a broad concept to health scientists in developing countries. "Systems ergonomics" is not applicable. On the contrary, the fact that ergonomics conveys a different meaning to those in developing countries is highlighted by a few examples from Sri Lanka. The author presents his view for consideration in the development of international instruments to prescribe the sale of guarded machinery to developing countries and the limitation of incentive schemes for performing arduous tasks leading to occupational illnesses.
Accidents, Occupational↗
Treatment of epilepsy: with special reference to developing countries.
1. Epilepsy, a common chronic neurological disorder, constitutes an important medical problem especially as in the developing countries there is a great dearth and shortage of health personnel, especially trained ones, in clinical neurosciences. The prevalence of epilepsy in developing countries is probably higher than in the Caucasians although accurate epidemiological data are lacking. 2. Epilepsy is discussed with special regard to the need for accurate diagnosis, and the difficulties encountered in developing countries. 3. Pharmacotherapy should be as simple as possible and suggestions are made on the essential drugs useful in the control of epilepsy with special reference to developing countries and in the context of economics and ready availability. Grand mal and focal epilepsies could be controlled by phenobarbitone, with phenytoin, sulthiame and carbamazepine kept as reserves or adjuncts. Minor (generalised) epilepsies could be controlled by ethosuximide, with clonazepam and sodium valproate (sodium dipropylacetate) as reserve drugs and adjuncts. For status epilepticus, diazepam is effective and readily available, with clonazepam and phenytoin as alternatives. 4. The problems in the management of epilepsy in the developing countries include lack of facilities and personnel to ensure accurate diagnosis and treatment, inadequate supply or non-availability of drugs, high defaulting rate of patients, the adverse and often pernicious social stigmatisation of the epileptic. 5. Possible solutions to some of these problems include integration of management (in simple terms) of convulsive disorders into the basic health system of delivery of health care in developing countries, aggressive pursuit of health education of the public by governmental and non-governmental agencies, active, intensive and sustained promotion of training of health personnel in clinical neurosciences and research aimed at producing long-acting anticonvulsants.
Africa↗
Medical treatment of sexually transmitted disease in developing countries I: Gonorrhoea.
The statistics relating to the incidence of sexually transmitted diseases in many developing countries are not available and where there are, they are unreliable. Nevertheless, the impression of many physicians is that they constitute serious public health problems as they are endemic in some developing countries. The facilities for diagnosis and treatment of the diseases have been briefly discussed. The merits and the demerits of various antimicrobial agents have been outlined with the causes of failure of treatment in the developing countries. The economic importance of the "traitment minute" in the tropical environment has been stressed because of its economic advantage in terms of time spent in overcrowded hospitals. The resultant effect of the widescale misuse of antibiotics in developing countries has been suggested as a cause of the increasing resistant strains encountered. A plea is made for stricter control of the antimicrobial agents in developing countries.
Ampicillin↗
Patterns of fertility decline in developing countries, 1950-75.
Since 1965 there have been substantial declines in the crude birth rates of many countries in the developing world, particularly the largest countries. This auspicious trend is shown clearly in an analysis of population figures for the last 25 years, despite the fact that there are deficiencies in the data. In 1950 the average crude birth rate for developing countries was 42 per thousand per year. Over the next 15 years, declines in the crude birth rate were limited to a relatively few, and for the most part small, countries. After 1965, however, for the 13 developing countries with a population numbering 35 million and over, there have been declines in the crude birth rate averaging 13 percent, with declines of over 12 percent in 9 of them. The effects of a number of sociodemographic factors on crude birth rates are examined, and the analysis shows that increases in the age at marriage and decreases in marital fertility were the principal factors affecting declines since 1965.
Adolescent↗
Physician importation--a solution to developing countries' rural health care problems?
Developing countries almost universally suffer from severe health service shortages, particularly in rural areas. Manpower problems are the most critical aspect of the shortages. Iran has recently begun a massive program to increase physician supply in its rural areas by importation of physicians from India, Pakistan, and the Philippines. The present study investigated two questions: What are physicians' reasons for accepting a post in a rural area of another country, and what are the attitudes of residents in such rural areas toward foreign physicians? Results of a questionnaire survey of foreign physicians indicate that the most common reasons for physician acceptance of the posts were higher salaries and the desire to go eventually to a Western country. Results of an interview survey of Iranian consumers indicate that residents of rural areas were far more likely to prefer Iranian auxiliaries than non-Iranian physicians.
Consumer Behavior↗
Mortality from tobacco in developed countries: indirect estimation from national vital statistics.
Prolonged cigarette smoking causes even more deaths from other diseases than from lung cancer. In developed countries, the absolute age-sex-specific lung cancer rates can be used to indicate the approximate proportions due to tobacco of deaths not only from lung cancer itself but also, indirectly, from vascular disease and from various other categories of disease. Even in the absence of direct information on smoking histories, therefore, national mortality from tobacco can be estimated approximately just from the disease mortality statistics that are available from all major developed countries for about 1985 (and for 1975 and so, by extrapolation, for 1995). The relation between the absolute excess of lung cancer and the proportional excess of other diseases can only be approximate, and so as not to overestimate the effects of tobacco it has been taken to be only half that suggested by a recent large prospective study of smoking and death among one million Americans. Application of such methods indicates that, in developed countries alone, annual deaths from smoking number about 0.9 million in 1965, 1.3 million in 1975, 1.7 million in 1985, and 2.1 million in 1995 (and hence about 21 million in the decade 1990-99: 5-6 million European Community, 5-6 million USA, 5 million former USSR, 3 million Eastern and other Europe, and 2 million elsewhere, [ie, Australia, Canada, Japan, and New Zealand]). More than half these deaths will be at 35-69 years of age: during the 1990s tobacco will in developed countries cause about 30% of all deaths at 35-69 (making it the largest single cause of premature death) plus about 14% of all at older ages. Those killed at older ages are on average already almost 80 years old, however, and might have died soon anyway, but those killed by tobacco at 35-69 lose an average of about 23 years of life. At present just under 20% of all deaths in developed countries are attributed to tobacco, but this percentage is still rising, suggesting that on current smoking patterns just over 20% of those now living in developed countries will eventually be killed by tobacco (ie, about a quarter of a billion, out of a current total population of just under one and a quarter billion).
Adult↗
The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries.
This article reviews the available evidence of mortality from acute respiratory infections (ARI) among children aged under 5 years in contemporary developing countries and compares the findings with European populations before 1965. In European populations before 1965, the level of mortality was found to be a determinant of the proportion of deaths due to ARI. There were marked differences according to regional patterns of mortality. Deaths from ARI played a smaller role after 1950, when the use of antibiotics became generalized. In developing countries, the role of ARI mortality seems to be similar to the European experience. The age pattern is very marked. In absolute values, ARI mortality is highest in the neonatal period and decreases with age. In relative values, ARI mortality is highest in the postneonatal period. ARI, mainly pneumonia, accounts for about 18% of underlying causes of death in developing countries. Pneumonia and other ARI are frequent complications of measles and pertussis; ARI is also commonly found after other infections and in association with severe malnutrition. Virtually no data are available in developing countries to provide final estimates of the role of ARI in mortality of children aged under 5 years. However, the WHO figure of 1 out of 3 deaths due to--or associated with--ARI may be close to the real range of the ARI-proportional mortality in children of developing countries. Results are discussed in light of the definitions of ARI used in various studies, the difficulties in ascertaining and coding multiple causes of death and the quality of data from some sources.
Acute Disease↗
[Epidemiological studies on viral hepatitis among long-term sojourners in the developing countries and evaluation of preventive measures].
It is known that acute viral hepatitis is very common among sojourners in developing countries. In order to conduct effective health control, epidemiological studies were made on viral hepatitis which occurred among Japanese staying in developing countries, and evaluations were carried out on preventive measures. The subjects of present study were a group of Japanese people staying in developing countries for two years. Mid year population of the group was 1732 in 1988. Period of the present study is ten years from 1979 to 1988. The study was conducted based on the reports from offices in each country, survey trips and serological studies on the subjects. In 1979, frequency of hepatitis A (HA) was very high showing 79% of total hepatitides. However after starting of inoculation of human immune serum globulin (ISG), the frequency of HA declined remarkably. Statistical significance was recognized in the efficacy of ISG. Among 35 cases of hepatitis B (HB) (34 males and 1 female), 2 derived from HBe antigen carrier while the remaining 34 were regarded as infected during their stay in developing countries. No cases of HB were recognized among those who received injections of HB vaccine. The rate of people whose HB marker turned positive during their stay is showing a tendency of increase (4.2% in 1987). The frequency of infection with HB virus is especially high in Asian and African countries where the carrier rates of native people were also high. Ten cases of non-A non-B hepatitis were recognized. Among them 7 were infected in Asia, 1 in Africa and 1 in Central America.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗