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PubMed1994

[Health status of schoolchildren in industrially developed and rural areas of West Siberia].

Medical examinations of the schoolchildren living in West Siberian urban and rural ares have revealed a high prevalence of chronic diseases and functional abnormalities. Children referring to health groups I and II were not found. This makes it necessary to perform such studies as a component of medical and ecological monitoring and as the basis for children's health promotion.

Child↗
PubMed1985

Bite-force variation related to occlusal variation in rural and urban Punjabis (North India).

Occlusal variation from defined norms was much less in traditional rural youths eating a rough unprocessed diet. Bite forces were significantly higher in the rural youths; their habitual harder chewing may help to being about their better occlusal development. Rural youths showed stronger increase with age and sex dimorphism than urban youths in bite force; thus, rurally the development of masticatory and facial structures may depend on functional masticatory demand.

Adolescent↗
PubMed1989

Nutritional impacts of an increasing fuelwood shortage in rural households in developing countries.

Developing countries face the problem of an increasing fuelwood shortage. For rural households, fuelwood is the main source of energy. As energy is essential to make food suitable for human consumption by means of cooking, the present fuelwood crisis could jeopardize the nutritional situation of rural households. This article reviews and analyses available data and information on the relationship between the availability of fuelwood and the nutritional situation of rural households. Based on analysis of emperical studies, three main strategies evolved by rural households, especially by the women within these households, to cope with a shortage of fuelwood can be distinguished: (i) increase in time and energy spent on fuelwood collection, (ii) substitution of fuelwood by alternative fuels and (iii) economizing on the consumption of fuelwood and alternative fuels. These coping-strategies affect food supply, food preservation, preparation and distribution, income generating activities and food consumption, all of which result in a decrease in quality and quantity of food consumed and in a deterioration of physical condition, especially women and their young children. Available data on fuelwood availability and nutrition are rather diffuse and incomplete. The presence of several confounding variables in the studies analysed make it difficult to establish the nutritional impact of a growing shortage of fuelwood. Nevertheless, it is concluded that a shortage of fuelwood plays at least an important role in changes in nutritional situation of rural households. If current trends continue, this role will become more important and evident. The impact of a growing fuelwood shortage should be a point of concern for rural development.

Cooking↗
PubMed1997

Rural health network development: public policy issues and state initiatives.

Rural health networks are a potential way for rural health care systems to improve access to care, reduce costs, and enhance quality of care. Networks provide a means for rural providers to contract with managed care organizations, develop their own managed care entities, share resources, and structure practice opportunities to support recruitment and retention of rural physicians and other health care professionals. The results of early network development initiatives indicate a need for state officials and others interested in encouraging network development to agree on common rural health network definitions, to identify clearly the goals of network development programs, and to document and analyze program outcomes. Future network development efforts need to be much more comprehensive if they are to have a significant impact on rural health care. This article analyzes public policy issues related to integrated rural health network development, discusses current efforts to encourage network development in rural areas, and suggests actions that states may take if they desire to support rural health network development. These actions include adopting a formal rural health network definition, providing networks with alternatives to certain regulatory requirements, and providing incentives such as matching grants, loans, or technical assistance. Without public sector support for networks, managed care options may continue to be unavailable in many less densely populated rural areas of the country, and locally controlled rural health networks are unlikely to develop as an alternative to the dominant pattern of managed care expansion by large urban entities. Implementation of Medicare reform legislation could provide significant incentives for the development of rural health networks, depending on the reimbursement provisions, financial solvency standards, and antitrust exemptions for provider-sponsored networks in the final legislation and federal regulations.

Antitrust Laws↗
PubMed1983

The Rural Area Project (RAP) in Thailand: curriculum development.

The Rural Area Project is a collaborative developmental project of Chulalongkorn University and the Ministry of Public Health in Thailand. The main objective of the project is to increase the number of doctors in the country in such a way that they would be posted in rural districts and have appropriate knowledge, skill and attitude for rural practice. Curriculum development for the project has been carried out to serve the project objective as well as to ensure that the project graduates are accepted as qualified doctors. Several principles and assumptions have been used as strategies in the developmental process. They include co-operative participation in curricular planning, systematic formulation of educational objectives, organization of common courses, utilization of existing health services, planning innovative courses in community medicine and general practice, extensive use of self-instructional modules, efficient use of teachers' time and planned gradual delegation of responsibility to students.

Community Medicine↗
PubMed1995

Lessons from the Essential Access Community Hospital Program for rural health network development.

The Essential Access Community Hospital (EACH) Program is testing a concept for limited-service hospitals established under Medicare called the Rural Primary Care Hospital (RPCH). The program uses cost-based reimbursement and relaxed regulatory requirements to help low-volume rural hospitals shift emphasis from acute care to primary care and emergency services. RPCHs must form "horizontal" networks with larger hospitals and may form "vertical" arrangements with ambulatory service providers and practitioners. A small number of rural hospitals have converted to the RPCH status since the program entered the implementation stage in late 1993. It is unclear how many other hospitals will convert given uncertainty regarding the financial impact of RPCH conversion and concerns with certain requirements. The program illustrates how payment policies can provide incentives for network development and reflects the importance of physician involvement and technical assistance in developing limited-service hospitals. In addition, it appears that EACH/RPCH networks that form under the program may serve as building blocks for broader networks, as the seven states involved in the program look to develop rural health networks that go beyond the EACH/RPCH model.

Comprehensive Health Care↗
PubMed2001

Newspaper reports as a source for injury data in developing countries.

Injuries are an important public health problem and a leading cause of death among adults and children. In most of the developing world, with rapid changes in lifestyle, rural development, urbanization, an increase in number of vehicles, introduction of mechanized farming and pesticides in agriculture, the effect of injuries on mortality and morbidity is expected to increase. Injuries have been infrequently studied in developing countries; their importance is incompletely understood and they are seriously neglected in health research and policy. The reasons for this situation may be many, but one important reason is the unavailability of data in countries to assess the magnitude of the problem. Hospital and police records are the primary data source for injuries in the majority of the developing world. Newspaper reports may be an alternative source for injury data. This hypothesis was tested in the Rawalpindi Division of Pakistan by collecting data from newspaper reports for both intentional and unintentional injuries for 6 months (January-June 1999). This was compared with police data for the same time period. The results revealed that newspapers report more injury-related events and for some categories, such as suicides, the reporting was far greater by newspapers than the police. We conclude that the current system of police data collection needs to be strengthened. Newspapers may serve as a comparative source of information to evaluate the coverage of police data.

Bibliometrics↗
PubMed1992

Towards a sustainable livestock production in developing countries and the importance of animal health strategy therein.

Livestock and animal health development projects have not always led to substantial increases in animal productivity or in farmers' welfare. Some have even resulted in unsustainable systems, when they were not based on an understanding of (livestock) production systems. The multipurpose functions of livestock and complex relationships between the biological, technical and social components require a systems approach, whereby nutrition, animal health, breeding, biotechnology knowhow, inputs and technologies are used to optimise resource use. The challenge for developed and developing countries is to reverse the current degradation of the environment, and arrive at sustainable increases in crop and livestock production to secure present and future food supplies. For rural development, governments should show long term commitment and political will to support the rural population in development programmes, because smallholders (including women and landless livestock keepers) represent a large labour force in developing countries. Different systems need different approaches. Pastoral systems must focus on effective management of grazing pressure of the rangelands. Communal rangelands management involves not only the development and application of technologies (e.g. feedlots, vaccination campaigns), but also land tenure policies, institutional development, economic return and a reduction in the number of people depending upon livestock. Smallholder mixed farms must aim at intensification of the total production system, in which external inputs are indispensable, but with the emphasis on optimum input-output relationships by reducing resource losses due to poor management. Resource-poor farming systems must aim at the improved management of the various livestock species in backyards and very small farms, and proper packages for cattle, buffaloes, sheep, goats, rabbits and poultry should be developed. Specialised commercial livestock farming systems (poultry, pigs, dairy or meat) can only be sustainable with adequate marketing, supply of quality feed, veterinary services, labour, management and control of pollution. Animal health programmes play a keyrole in the proposed system approach.

Agriculture↗
PubMed1994

Lao People's Democratic Republic Veterinary Public Health Project.

From May 21 to June 4, 1993, a collaborative training project involving U.S. Army veterinary personnel, the Lao-American Integrated Rural Development Project, and the Lao Department of Livestock and Veterinary Services occurred in the Houa Muang District of Houa Phan Province in northeastern Laos. The project focus was control of the major animal diseases of economic or public health importance in the area to include, but not limited to, hemorrhagic septicemia, anthrax, swine fever (hog cholera), and Newcastle disease. The project provided Lao veterinary personnel and villagers with didactic training and field demonstrations in disease control practices. Supplies and equipment necessary to continue disease control activities were provided to the district at the conclusion of the training and field demonstrations. The project was designed to be compatible with disease reporting and surveillance systems at district, province, and national levels and be exportable to other districts and provinces. In addition to disease-control efforts, blood and fecal parasite surveys were conducted.

International Cooperation↗
PubMed1995

The tooth as a marker of developing world quality of life: a field study in Guatemala.

A geographical sample in a rural area of eastern Guatemala revealed widespread, premature and heavy losses of permanent teeth. Social and environmental influences that affect tooth loss include inadequate diet, refined sugar, poor oral hygiene, absence of fluoride, lack of preventive education and insufficiency of dental care services. Land hunger and family poverty are of paramount importance. Gender-based cultural differences are apparent in tooth extraction rates, and use of dentures. No one escapes visitations of severe orofacial pain that cast a blight upon the quality of rural life. Periodontal disease drives the poorest of the poor to spend disproportionately large sums on pharmaceutical pain-killers and destructive traditional medicines. Lay 'tooth-pullers' visit remote rural homes to extract teeth. Only full edentulism can bring patients permanent somatic and financial relief. Community dental health is conspicuously neglected in official policies and plans for rural development.

Adolescent↗
PubMedDate not supplied

Health organization in developing countries: innovations in the Peoples Republic of China.

The medical care delivery systems of most low-income countries are largely patterned on those of industrialized societies and are ill suited to the needs of developing countries. The present alternative model of health care in China has evolved after prolonged and often bitter debate extending over twenty years. The system that has been developed is one that appears uniquely suited to the needs of a large rural developing country; but it has been achieved in large part not through the medical profession but by evolving a system based upon participation by the people themselves and the development of new health-worker roles.

China↗
PubMed1995

Primary health care and donor dependency: a case study of nongovernment assistance in Burkina Faso.

Primary health care assistance has become prominent in the rural development programs of many nongovernment organizations throughout sub-Saharan Africa. By emphasizing education and the promotion of new participatory health systems, most such programs aim to enhance the conditions of women as principal community care givers. Yet village-level health assistance in Africa is not without shortcomings. This is exemplified in a case study of two nongovernment programs in Burkina Faso's Namentenga Province. Although both programs have contributed to maternal health and infant survival, they have also induced new ties of donor dependency. This appears to present a conundrum for the sponsoring agencies which espouse self-reliance as a development assistance goal. In fact, however, where the intervention of nongovernment organizations helps to improve rural health, new dimensions of dependency may prove to be a positive first stage in the mobilization of women and the development of locally managed health systems. For this to be so, much is contingent on the capacity of these organizations to integrate local participation in their own planning and management processes, and to augment the professional status of indigenous health workers.

Adolescent↗