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At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Managing the ecosystem to improve human health: integrated approaches to safe drinking water.

The ecosystem approach to human health is a holistic concept of health for both humans and the environment in which they live. This approach requires a holistic management of all facets of the ecosystem, be they physical, biologic, or indeed human-such as culture, economy, and developmental needs. This paradigm may at first glance seem theoretical and difficult to put into practice in everyday field research. However, using basic human needs, such as water and sanitation, as entry points illustrates how ecosystem health can indeed prove a powerful tool for sustainable development, promoting both human well-being and sustainable ecosystems. The authors describe the efforts of international agencies, particularly the International Development Research Centre (IDRC), to promote household safe drinking water security in developing countries. Essential to the success of these endeavors are strong partnerships with communities, research institutions, and donor agencies. The roles of these players are delineated. An important feature of IDRC projects, which is critical to their success, is the establishment of a simple, community-based water-quality monitoring program that the people can maintain with the limited resources available to them. The process and outcomes of past IDRC projects are presented and ongoing efforts are described.

Community Participation↗
PubMedDate not supplied

Organizational development and privatization: a Bolivian success story.

This article presents a case study of a US Agency for International Development-sponsored privatization effort in Bolivia. This privatization effort differs from AID's more common approach in that rather than merely helping already existing organizations to expand, this project has created a new organization. More ambitious and encompassing, this approach is also preferable because it directly addresses one of the most serious bottlenecks to economic development, viz., organizational development. The article describes the evolution of PROSALUD, a private, non-profit network of 17 community-sponsored health centers. The article describes factors and characteristics which have either conditioned or have directly contributed to PROSALUD's success. First, PROSALUD's health care environment is analysed, starting with a broad brush profile of select characteristics and trends which exist throughout the health sector of Bolivia, then narrows the focus to the local health sector. The structure and operations of PROSALUD are then analysed, focusing on the organization's managerial practices and financing and the series of tradeoffs it has been forced to strike: in its pricing strategy, between striving for financial viability and maintaining access to care; between, on the one hand, responding to community needs and demands and improving coverage by opening more facilities, and, on the other hand, focusing managerial efforts and outreach on a more limited number of clinics and neighborhoods; between providing a socially desirable mix of services--in particular, continuing to provide a great deal of free preventive care--and focusing care on more lucrative curative services; between maintaining commitments to neighborhoods and communities and eliminating the less economically viable (especially rural) clinics.

Bolivia↗
PubMedDate not supplied

A cost analysis of family planning in Bangladesh.

This article presents a step-down cost analysis using secondary data sources from 26 Bangladesh non-government organizations (NGOs) providing family planning services under a US Agency for International Development-funded umbrella organization. The unit costs of the NGOs' Maternal-Child Health (MCH) clinics and community-based distribution (CBD) systems were calculated and found to be minimally different. Several simulations were conducted to investigate the impact of alternative cost-reduction measures. The more general financial analysis proved more insightful than the unit cost analysis in terms of identifying means by which to improve the efficiency of the family planning operations of these NGOs. The analysis revealed that 56 per cent of total expenditures in the two-tiered umbrella's organizational structure are incurred in management operations and overheads. Of the remaining 44 per cent of project expenditures, 39 per cent is spent on the CBD program and 5 per cent on the MCH clinics. Within the CBD program, most resources are spent providing 4 million contacts (two-thirds of the annual total) which do not involve contraceptive re-supply. The clinics devote more resources to providing MCH services than to providing family planning services. The findings suggest that significant savings could be generated by containing administrative costs, improving operational efficiency, and reducing unnecessary or redundant fieldworker contacts. The magnitude of the potential savings raises a fundamental question about the continued viability and sustainability of this supply-driven CBD strategy.

Adult↗
PubMed1990

International politics and primary health care in Costa Rica.

Costa Rica's internationally-renowned rural health program exemplifies the principles put forth by the 1978 Alma Ata Declaration on Primary Health Care with one exception: the government has not succeeded in achieving active community participation in health. This paper uses a historical and political-economic perspective to explain why the Costa Rican government failed in its efforts to enhance community participation after Alma Ata. International agencies have been closely involved in the design and implementation of rural health services in Costa Rica since the early 1900s, yet community participation did not figure in these programs until the mid-1970s. The demise of community participation in the early 1980s is attributed to a combination of factors including partisan conflicts, social class conflicts, interest group politics and, particularly, to the shifting priorities of international health and development agencies.

Community Health Services↗
PubMed1993

Study and introduction of family planning methods in developing countries.

Research in developing countries is essential for the evaluation of the safety, efficacy and acceptability of both new and already available contraceptives. Research conducted by scientists in developing countries has also played an essential role in the development of new contraceptives. The continuous delivery of progestin at a low dose, copper IUDs, contraceptive implants, monthly injectables and vaginal rings are examples of new methods developed with the input of research conducted largely in developing countries. When research in developing countries is funded or coordinated by international agencies, local scientists have to be involved not only in its implementation, but in the planning, analysis and dissemination of such research. The World Health Organization, the Population Council and Family Health International have played an important role in supporting collaborative studies for the development, introduction and evaluation of family planning methods in developing countries.

Developing Countries↗
PubMed1978

Radioassay services in developing countries. Findings and recommendations of an International Atomic Energy Agency advisory group.

The findings and recommendations of an advisory group convened by the IAEA to give guidance relating to the development of IAEA projects involving radioassay are presented. The current status of radioassay services in different countries is reviewed; guiding principles relating to the organization of such services are affirmed, with particular reference to services in developing countries; the needs of services at various levels as regards accommodation, staff, equipment, supporting services and running costs, including minimum initial needs, are specified; operational problems are identified and indications given how they may be solved; facilities for training in radioassay are reviewed; finally, reference is made to IAEA activities in the field in question.

Austria↗
PubMedDate not supplied

[Regional initiative on health care reform in Latin America and the Caribbean].

Many countries throughout Latin America and the Caribbean are introducing reforms that can profoundly influence how health services are provided and who receives them. Governments in the region identified the need for a network to support health reform by building capacity in analysis and training, both at the Summit of the Americas in 1994 and at the Special Meeting on Health Sector Reform, which was convened in 1995 by an interagency committee of the Pan American Health Organization/World Health Organization, the Inter-American Development Bank, the World Bank, and other multilateral and bilateral agencies. In response, in 1997 the Pan American Health Organization and the United States Agency for the International Development launched the Latin America and Caribbean Regional Health Sector Reform Initiative. The Initiative has approximately US$ 10 million in funding through the year 2002 to support activities in Bolivia, Brazil, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Paraguay, and Peru. Now in its third year of implementation, the Initiative supports regional activities seeking to promote more equitable and effective delivery of basic health services.

Caribbean Region↗
PubMed1988

Perspectives in human reproduction.

In-vitro fertilization and embryo transfer represent only one of the rapidly emerging applied advances in reproductive medicine beginning in the late 1950s; these include 'the pill' and the IUD for contraception, and hormones for the infertile requiring gonadal stimulation by gonadotrophins, clomiphene citrate or bromocryptine, to mention but a few. But from where and when did the biological basis for these sweeping changes derive? Virtually all the recent applications grew out of imaginative basic research. Fundamental animal studies by pioneers, such as Chang, Thibault and Edwards, taught us nature's axioms for gametogenesis, fertilization, development and differentiation. Millions are now seeking voluntary manipulation of their intrinsic reproductive capabilities to gain quality of life benefits for themselves and their children. Although not universal, the popularity of such options sparked industrial investment, governmental policies and international agencies to promote development of safer, more effective drugs and devices. Increased advocacy of aggressive treatment for infertile couples was a spontaneous outgrowth of this movement. Thus, the right of individuals to procreate, even to pursue the extraordinary means required, arose from the diverse events of the nascent reproductive revolution.

Biomedical Research↗
PubMedDate not supplied

[Vinyl chloride and 1,2-dichloroethane: classification and assessment of carcinogenicity, guidelines, threshold values, and standards developed by national and international entities, organizations, and agencies].

International, national and regulatory classification, evaluation, guidelines and occupational exposure values regarding vinyl chloride and 1,2-dichloroethane, carried out by European Union (EU). Environmental Protection Agency (US EPA), International Agency for Research on Cancer (IARC), Italian National Advisory Toxicological Committee (CCTN), Occupational Safety and Health Administration (OSHA), World Health Organization (WHO), National Institute for Occupational Safety and Health (NIOSH), American Conference of Governmental Industrial Hygienists (ACGIH) and other institutions, have been considered with particular reference to the carcinogenic effects. Moreover information is reported in support of classification and evaluation and a short historical review since early 1970s, when first evidence that occupational exposure to VC could lead to angiosarcoma was published.

Carcinogens↗
PubMed2002

The IARC TP53 database: new online mutation analysis and recommendations to users.

Mutations in the tumor suppressor gene TP53 are frequent in most human cancers. Comparison of the mutation patterns in different cancers may reveal clues on the natural history of the disease. Over the past 10 years, several databases of TP53 mutations have been developed. The most extensive of these databases is maintained and developed at the International Agency for Research on Cancer. The database compiles all mutations (somatic and inherited), as well as polymorphisms, that have been reported in the published literature since 1989. The IARC TP53 mutation dataset is the largest dataset available on the variations of any human gene. The database is available at www.iarc.fr/P53/. In this paper, we describe recent developments of the database. These developments include restructuring of the database, which is now patient-centered, with more detailed annotations on the patient (carcinogen exposure, virus infection, genetic background). In addition, a new on-line application to retrieve somatic mutation data and analyze mutation patterns is now available. We also discuss limitations on the use of the database and provide recommendations to users.

Computational Biology↗
PubMedDate not supplied

[Congenital syphilis: update and perspectives].

Congenital syphilis is responsible for a variety of clinical symptoms, from subclinical attacks to septicemic forms that may be fatal. The most frequently encountered forms typically involve low birth weight, heptosplenomegaly and jaundice. Premature birth, anemia, cutaneous lesions, coryza, anasarca and pseudoparalysis may also occur. Neonatal X rays generally show characteristic but nonspecific osteochondrocyte lesions and periosteous dystrophy. A clinical form partly associated with growing tissues may be detected late. Diagnosis of fetal syphilis depends on the detection by immunofluorescence of specific IgM immunoglobulins in the newborn. Parenteral antibiotic treatment with 100,000 IU penicillin/kg.day for 15 days is given to newborns with symptoms. The classification and treatment of asymptomatic forms is unclear. A single injection of benzathine-penicillin is a good compromise between simple surveillance and admission to hospital for 10 days of intravenous treatment. In any case, serological surveillance is required to check that IgM disappears from the blood or that the titer of IgG decreases. Reinfection is always possible, even in a newborn treated correctly. In developing countries, pediatricians must be aware of the various clinical forms of congenital syphilis. In addition, national programs to combat sexually transmitted diseases should be supported and developed by international aid agencies. In economically advanced countries, attention is currently focused on the restricted nature of medical treatment. Improvements in the management of congenital syphilis depend above all on dealing with the social and cultural problems of populations affected by syphilis.

Adult↗
PubMedDate not supplied

Obstetric first aid in the community--partners in safe motherhood. A strategy for reducing maternal mortality.

The unacceptably high levels of maternal mortality that are prevalent throughout the developing world are a product of many factors; most notably, these include nonexistent, inaccessible or inadequate facility-based emergency care, poorly developed referral linkages, predominance of home-based care by attendants and family members who are poorly equipped to respond to emergencies, and the complexities of problem recognition and decision making during emergencies leading to inappropriate or delayed action. This paper describes an innovative community-oriented strategy that has been designed to reduce maternal mortality and that targets women, families, and traditional birth attendants (TBAs) using two complimentary training interventions. The strategy reflects the authors' conviction that the training of professional and paraprofessional health workers in emergency care is essential, but that it must be complemented by the education and mobilization of families, communities, and TBAs who must, in turn, come to common perceptions on the need for and means of intervening to prevent a maternal death. Collaborating with partners in the US Agency for International Development-funded Primary Providers Training and Education in Reproductive Health Project. Special Project staff of the American College of Nurse-Midwives will lead development and testing of the strategy through operations research activities in selected countries.

Community Health Services↗
PubMed1999

Agricultural policy and sustainable livestock development.

Future agricultural and rural development is, to a large extent, influenced by the projected food needs of 2.5 billion people expected to swell the world population by 2020. This increase will require more food in general and, in view of recent experience in East Asia, more animal products. To achieve this increase will require judicious use of resources, and trade, especially in those countries where natural resources are insufficient to support food production. Achieving food sufficiency in a sustainable manner is a major challenge for farmers, agro-industries, researchers and governments. The latter play an important role as many of the farmers' choices are, to a large extent, directed by government or supra-government, often through macro- and micro-economic policy. In many countries the economic, environmental, trade and agricultural policies have not been conducive to an agricultural development that is risk-free with respect to the environment, animal welfare or public health. The recent decline of government support in agriculture forced farmers in Western countries to think about more risk adverse agricultural practices and more efficient production systems. On the other hand, many countries in Eastern Europe and the former Soviet Union, as well as other developing countries, are still going through a painful process of adjustment to new market conditions. International banks and development agencies have a mandate to help developing countries, but are somewhat restricted both by needing to work directly with governments and by their perceived dogmatic approach to development. Changing policies do, now and in the future, also affect the development of animal disease control programmes, including the control of parasitic diseases. On the one hand there is an increasing interest in risk-free control practices, and on the other hand a demand for greater regulatory control over the production process. As parasitic diseases of animals are closely linked to the environment (i.e. grazing and waste management) and public health (i.e. parasitic zoonoses), the new interest in sustainable agriculture provides a challenge for those concerned with the control and prevention of animal parasitism.

Agriculture↗