[The effect of congresses of rural physicians on the development of rural surgery].
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Congresses as Topic↗
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[Health and the development of a rural health service system].
The first part of this article reviews the interesting experience of the Center for Multidisciplinary Research in Rural Development (CIMDER) of Cali, Colombia, in the application of a model for the integrated development of health services. The strategies used in the model were: services available to all individuals and families in the community, use of accessible technology, community participation, and cooperation between the health sector and other development sectors. The second part briefly reviews the role of the nurse in health and development and takes issue with the traditional narrow view of the sphere of action of nursing as a profession. It is asserted that, in order to bring about the extension of health services and community development, it is necessary that the nurse serve in a position of leadership on a multidisciplinary team as either coordinator of services, supervisor of personnel, or education, and as liaison for the formal health care system with the community to enlist its active participation.
Colombia↗
Rural perinatal center. Development of a rural level II perinatal center.
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Child Health Services↗
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↗
Effects of agricultural development policies on migration in peninsular Malaysia.
State planning plays a central role in Malaysia's social and economic development. The government's rural development policies are designed to promote agricultural incomes and help counterbalance ethnic inequalities. The Federal Land Development Authority (FELDA) implements one of the internationally most successful land development and resettlement programs. In this article, we quantify the impact of FELDA settlements on local out-migration rates, linking macro and micro approaches and using data from the Malaysian Family Life Survey, national censuses, and other sources. A model of instantaneous migration rates specifies an individual's migration rate as a function of individual-level sociodemographic characteristics, the level of urbanization of the origin and destination, and the extent of rural development at the district of current residence. Our results show that in the late 1960s and early 1970s, the existence of rural development centers in a district reduced the levels of out-migration to pre-1965 levels.
Agriculture↗
A process for developing a rural training track.
BACKGROUND AND OBJECTIVES: This article describes the process used by the University of Wisconsin-Madison Family Practice Residency Program to establish its first rural training track (RTT) in Baraboo, Wis. The process includes 1) establishing a core planning group to develop rural site selection criteria with specifications on distance traveled, faculty composition, teaching commitment, rural hospital capabilities, and availability of subspecialty teaching, 2) involvement of the state Area Health Education Center, 3) budget planning, 4) telecommunications plans, including e-mail, library search, and Internet connectivity, 5) creation of a residency curriculum in collaboration with the rural site's faculty and staff, 6) preparing an accreditation document to submit to the Residency Review Committee, and 7) faculty development programs for rural faculty. The program then participates in the National Residency Matching Program with an independent Match number.
Accreditation↗
Foreign aid and its role in maintaining the exploitation of the agricultural sector: evidence from a case study in Africa.
Today most foreign aid donors are genuinely committed to the idea that development in Third World countries should start with rural development. Therefore, a sizable proportion of their development funds are invested in rural projects. However, donors channel these funds through local governments (most often representing local bourgeois interests) that are not as committed to the principle of rural development. These governments are often also embarked in policies that are actually--directly or indirectly--expropriating the surpluses generated by agriculture and investing them in the other sectors of the economy. The peasants are therefore footing most of the bill of overall national development. This paper contends that, because of this state of affairs, foreign aid directed toward rural development is actually filling the investment gap left by an internal system of unequal returns to production in agriculture. In so doing, foreign aid is indirectly financing the development of the other sectors of the economy, even if this result is unintended. This perpetrates maldevelopment without redressing the basic exploitation process of peasants which lies at the core of underdevelopment. Evidence to support this hypothesis is presented using data from a primarily agricultural exporting country: the United Republic of Cameroon.
Agriculture↗
Developing a rural therapy with big city approaches.
Both rural communities and urban communities experience problems associated with drug use and drug dependence. However, existing treatment interventions are not tailored for rural settings. This article describes a project which will modify an existing social skills behavioral therapy for rural populations, refine the therapy, develop a manual, train and supervise therapists, and pilot test the structured behavioral outpatient rural therapy to treat rural drug users and drug dependents as Stage I Research for NIDA's Behavioral Therapies Development Program.
Behavior Therapy↗
Health and rural-to-urban migration in Thailand. The Population and Community Development Association's experience in rural development.
The Population and Community Development Association (PDA), a non-governmental organisation, has designed and implemented a new model of rural economic development in which health is considered to be the cornerstone of all development strategies. By attacking migration as the root cause of current threats to the population's health, PDA's Thai Business Initiative in Rural Development program provides economic opportunities to villagers in the poorest areas of the country. This structural approach to health enhancement includes specific components to address primary health care, family planning, and HIV/AIDS prevention, education and care.
Acquired Immunodeficiency Syndrome↗
Legislative and policy strategies for supporting rural health network development: lessons from the 103rd Congress.
There was considerable support in most major health reform bills considered by the 103rd Congress for the development of rural integrated service networks. The demise of comprehensive health reform, together with the pace of current market-driven changes in the health care system, suggests the need to assess the impact of specific policy strategies considered in the last Congress on rural integrated service network development. Toward this end, this article evaluates the rural health policy strategies of the major bills in relation to three essential preconditions for the development of rural integrated service networks: (1) the need for a more stable financial base for rural providers; (2) the need for administrative, service and clinical capacity to mount a successful network; and finally, (3) the need for appropriate market areas to ensure fair competition among networks and plans. Key policy strategies for supporting rural network development include reform of insurance and payment policies, expansion of targeted support and technical assistance to the underserved, limited-capacity rural areas, and policies governing purchasing groups or alliances that will ensure appropriate treatment of rural providers and networks.
Comprehensive Health Care↗
Human resource development in rural health care facilities.
In this paper, human resource development problems facing rural health care facilities are identified and it is recognised that, particularly in the face of escalating demands for training arising from environmental pressures such as implementation of the structural efficiency principle, a coordinated approach to meet these problems is desirable. Such coordination is often sought via a regional staff development service. Accordingly, using the organisational life cycle as a conceptual framework, staff development services in five NSW health regions are examined. Ranging from a cafeteria style to a results-orientation, a diversity of strategic approaches to staff development is reflected.
Geography↗
The impact of nagana.
The disease in cattle, called nagana in Zululand, was linked with trypanosomal parasitaemia and tsetse flies. Nagana occurs in livestock throughout the tsetse belts of Africa. Wild animals are tolerant of trypanosomal infections. Nagana affects individual animals, herds and socio-economic development. In susceptible animals nagana may be acute, but chronic infections are more common. The host-parasite interaction produces extensive pathology and severe anaemia. Clinically affected animals lose condition and become weak and unproductive. Nagana is often fatal and, at herd level, its impact is wide ranging. All aspects of production are depressed: fertility is impaired; milk yields, growth and work output are reduced; and the mortality rate may reduce herd size. Africa has to feed its rapidly growing human population, and animal products are a vital dietary component. However, in most tsetse areas, there is not enough meat and milk. Furthermore, animal draft power is often not available, which limits cultivation and local transport. These factors lower household incomes and retard socio-economic development. Sustainable rural development requires that nagana be controlled. This in turn needs considerable resources, whichever control strategy is adopted.
Animals↗
Rural nursing: developing the theory base.
Many health care needs of rural dwellers cannot be adequately met through the use of existing nursing models alone but require unique approaches emphasizing the special needs of this population. The development of an integrated theory base for rural nursing is necessary. A retroductive approach, building upon both qualitative and quantitative research data, is being used to develop a theory of rural nursing. Key concepts identified are: work beliefs and health beliefs; isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer. Implications for practice include the importance of relating health care to work practices and the need to intervene indirectly through established informal systems.
Attitude to Health↗
Participatory health development in rural Nepal: clarifying the process of community empowerment.
Community-based participatory development empowers villagers to develop community cohesion and confidence, increase their ability to identify, analyze, and priorize their own needs, and organize the resources to meet these needs. An important first step in the process involves establishing a cohesive and functional community group. The authors believe that this is best accomplished through villagers' critical examination of their experiences with development including their understanding of reasons for success or failure, and the gradual emergence of a model of working together that acknowledges and builds on participation and collective expertise. This approach to development is demonstrating encouraging results in a rural area of western Nepal in a university affiliated Canadian/Nepali Health Development Project. This paper describes two mini-projects to illustrate the evolution of group formation through reflection, analysis, and action, and identifies outcomes that could serve as indicators of community empowerment. The paper also presents a generic model of empowerment, and offers lessons learned by the project through the application of the empowerment process to sustainable health development.
Community Participation↗
[Comparison of skeletal development between rural and urban school-age children].
Skeletal development and other related indicators were measured in 1680 children aged 7-18 in urban areas of Harbin and rural areas of Hailun County in 1990-1992, and comparisons were made. The results showed that the skeletal age of urban children aged 7-17 was higher than that of rural children in both sexes, and this difference was significant in the early puberty stage. The difference in mean values of cortical thickness of the metacarpals between urban and rural children showed similar tendency. Sesamoid ossification in urban children occurred one year earlier than that in rural children in both sexes. In primary school-age children, skeletal age was highly correlated with body height and weight. The development of secondary sex characteristics in both sexes and the age at menarche in girls in urban areas were earlier than those in rural areas, and the onset of puberty occurred one year earlier in urban than that in rural children.
Adolescent↗
[Strategy for monitoring and implementing methods for correcting child growth and development in rural areas of Sonora. Mexico].
An appropriate health technology to facilitate child growth and development in a rural area is presented and documented. Because mother's adequate behavior related to child's care does not produce immediate behavioral or physical changes it is necessary to create a long term social system of consequences. This was achieved joining a longitudinal measurement system with a program to train mothers to identify and deal with health and development issues. During four years, data were collected on weight-length development and morbidity twice a year and simultaneously skills were taught to diagnose treatment and prevent growth and development problems. After the third session child development and anthropometry data became the base of a system to assess maternal behavior, providing consequences for links in the behavior chains associated with child care. This system made organization and participation of the community in primary health care programs more likely, which implied a better score in each child growth and development chart.
Adult↗
Development of rural health services: problems illustrated by a nonprofit, privately-based approach.
The historic development of a nonprofit organization designed to improve rural health services in Colorado is described and some of the major problems of rural health are discussed. This corporation, originally derived from four different kinds of provider organizations, has developed a comprehensive approach to improving the utilization of existing rural health resources and to the recruitment and deployment of new resources. Emphasis has been placed on community involvement, decreasing the isolation of rural physicians by linking rural practices with urban resources, centralizing supportive services and development of quality control methods. The peculiarities of the target area and the evolution of the goals and methods of the organization are described in order to facilitate the adaptation of these concepts to other areas.
Colorado↗
Secondary sexual development in rural and urban South African black children.
The timing and duration of secondary sexual development in two samples of rural and urban South African black children were investigated using the Tanner staging techniques and compared to similar data from Switzerland and England. In general rural black children were consistently delayed in the age at which they entered the events of puberty, and took longer to pass through each of the stages. Urban black children, from good socioeconomic backgrounds, were advanced in relation to their rural peers and slightly ahead of the European samples. There were no significant differences in the sequence of events. Estimates of testicular volume on the well-off urban boys demonstrated that they exhibited similar volumes to European boys at similar ages. It is suggested that the British clinical longitudinal growth standards could be effectively used to sensitively monitor the growth and maturation of black urban children from good socioeconomic backgrounds.
Adolescent↗