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S0004-05922010000100015 | language | EN | section | title | -1 | sentnum | 0 | -1 | Response of broiler chicks to diets with bambaranut (Voandzeia subterranea) as a protein source | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The effects of raw and toasted bambaranut as a protein source for broiler chicks were investigated using 45 broiler chicks, randomly divided into three groups of 15 birds each. | sentnum | 1 | -1 | The test diets were formulated such that bambaranut constituted 25% of the diets. | sentnum | 2 | -1 | Treatment 1 (control) contained no bambaranut, treatment 2 contained raw bambaranut and treatment 3 toasted bambaranut. | sentnum | 3 | -1 | The study lasted for 6 weeks during which weight gain and feed consumption were measured. | sentnum | 4 | -1 | The performance of the various groups was evaluated using weight gain, feed conversion ratio and cost per kg weight gain. | sentnum | 5 | -1 | At slaughter, various internal organs were excised, evaluated for gross lesions and weighed. | sentnum | 6 | -1 | The results of the study showed that the control group had superior feed conversion ratio and weight gain, while the raw bambaranut group was superior to the toasted bambaranut group. | sentnum | 7 | -1 | Cost per kg weight gain was higher in the toasted bambaranut groups. | sentnum | 8 | -1 | There were neither statistically significant differences (p>0.05) in the organ weights nor observable abdominal fat and gross pathology of the internal organs. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0004-05922011000300039 | language | EN | section | title | -1 | sentnum | 0 | -1 | Effects of reducing postpartum re-mating timeperiod on reproductive performance of the doe | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Rabbits being induced ovulators can be rebred within 24 hours after parturition. | sentnum | 1 | -1 | However, reproductive efficiency and the doe's physiology can be affected by postpartum re-mating interval. | sentnum | 2 | -1 | This study evaluated the effects of reducing the re-mating interval after parturition on sexual activity, fertility, gestation, parturition and litter characteristics using 90 does. | sentnum | 3 | -1 | Three groups of crossbred (New Zealand White × Chinchilla) does were used in a randomized complete block design. | sentnum | 4 | -1 | Does were re-mated 1-9, 10-20 and 21-28 days after parturition in the dry and rainy seasons in Ayetoro, Ogun State, Nigeria. | sentnum | 5 | -1 | Acceptance of mating decreased with increasing postpartum remating interval. | sentnum | 6 | -1 | Conception rate was highest in the 21-28 days group (98.8%) and lowest in the 1020 days group (68.4%). | sentnum | 7 | -1 | Gestation length was significantly shorter (p<0.05) in the 10-20 days group (30.7 days), than 1-9 days group (31.6 days) and 21-28 days group (31.7 days). | sentnum | 8 | -1 | Litter size and weight at birth were not significantly affected. | sentnum | 9 | -1 | Kit's mortality was lower (p<0.05) in the 21-28 days group (25.6%) compared to 10-20 days group (57.4%) and 1-9 days group (58.8%). | sentnum | 10 | -1 | Litter weight (total and alive at birth) was heavier (p<0.05) during the rains (295.9 and 294.9 g) than dry season (250.1 and 243.3 g). | sentnum | 11 | -1 | Reducing the re-mating interval after parturition enhanced sexual activity. | sentnum | 12 | -1 | Fertility was comparable in does re-mated 1-9 and 21-28 days after parturition. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0004-05922013000200020 | language | EN | section | title | -1 | sentnum | 0 | -1 | Factors influencing reproduction parameters of ewes Ouled Djellal | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The study of the reproductive parameters of the ewes Ouled Djellal (n=269), conducted in semiintensive in semi-arid environment, shows a fertility rate of 88 %, a fecundity rate of 95 % and a prolificacy rate was 111 %. | sentnum | 1 | -1 | The influence of different factors on the reproduction parameters, highlights on fertility, a significant influence (p<0.05) of the physiological state during the mating, an effect very significant of ewes age and a result highly significant (p<0.001) of mode of mating, of month of mating and for the interaction of physiological state during the mating × mode of mating. | sentnum | 2 | -1 | For fecundity, there is a significant effect (p<0.05) of the ewes age, very significant (p<0.01) of the physiological state during the mating and highly significant (p<0.001) for mode of mating and the month of mating. | sentnum | 3 | -1 | As for prolificacy, it is significantly influenced by the physiological state during the mating and very significantly by the month of mating. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000100003 | language | EN | section | title | -1 | sentnum | 0 | -1 | Socioeconomic inequalities in child mortality: comparisons across nine developing countries. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | This paper generates and analyses survey data on inequalities in mortality among infants and children aged under five years by consumption in Brazil, Côte d’Ivoire, Ghana, Nepal, Nicaragua, Pakistan, the Philippines, South Africa, and Viet Nam. | sentnum | 1 | -1 | The data were obtained from the Living Standards Measurement Study and the Cebu Longitudinal Health and Nutrition Survey. | sentnum | 2 | -1 | Mortality rates were estimated directly where complete fertility histories were available and indirectly otherwise. | sentnum | 3 | -1 | Mortality distributions were compared between countries by means of concentration curves and concentration indices: dominance checks were carried out for all pairwise intercountry comparisons; standard errors were calculated for the concentration indices; and tests of intercountry differences in inequality were performed. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000100005 | language | EN | section | title | -1 | sentnum | 0 | -1 | Defining and measuring health inequality: an approach based on the distribution of health expectancy. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | This paper proposes an approach to conceptualizing and operationalizing the measurement of health inequality, defined as differences in health across individuals in the population. | sentnum | 1 | -1 | We propose that health is an intrinsic component of well-being and thus we should be concerned with inequality in health, whether or not it is correlated with inequality in other dimensions of well-being. | sentnum | 2 | -1 | In the measurement of health inequality, the complete range of fatal and non-fatal health outcomes should be incorporated. | sentnum | 3 | -1 | This notion is operationalized through the concept of healthy lifespan. | sentnum | 4 | -1 | Individual health expectancy is preferable, as a measurement, to individual healthy lifespan, since health expectancy excludes those differences in healthy lifespan that are simply due to chance. | sentnum | 5 | -1 | In other words, the quantity of interest for studying health inequality is the distribution of health expectancy across individuals in the population. | sentnum | 6 | -1 | The inequality of the distribution of health expectancy can be summarized by measures of individual/mean differences (differences between the individual and the mean of the population) or inter-individual differences. | sentnum | 7 | -1 | The exact form of the measure to summarize inequality depends on three normative choices. | sentnum | 8 | -1 | A firmer understanding of people’s views on these normative choices will provide a basis for deliberating on a standard WHO measure of health inequality. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000100007 | language | EN | section | title | -1 | sentnum | 0 | -1 | Public spending on health care in Africa: do the poor benefit?. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Health care is a basic service essential in any effort to combat poverty, and is often subsidized with public funds to help achieve that aim. | sentnum | 1 | -1 | This paper examines public spending on curative health care in several African countries and finds that this spending favours mostly the better-off rather than the poor. | sentnum | 2 | -1 | It concludes that this targeting problem cannot be solved simply by adjusting the subsidy allocations. | sentnum | 3 | -1 | The constraints that prevent the poor from taking advantage of these services must also be addressed if the public subsidies are to be effective in reaching the poor | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000100017 | language | EN | section | title | -1 | sentnum | 0 | -1 | Deterioration in the nutritional status of young children and their mothers in Brazzaville, Congo, following the 1994 devaluation of the CFA franc. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The effects of the January 1994 devaluation of the African Financial Community (CFA) franc on the nutritional situation of the populations concerned has been little documented. | sentnum | 1 | -1 | We report in this article on two nutritional cross-sectional surveys that were conducted before and after this devaluation (1993 and 1996) in two districts of Brazzaville, Congo. | sentnum | 2 | -1 | The surveys involved a representative sample of 4206 households with a child aged 4-23 months. | sentnum | 3 | -1 | Complementary feeding practices and the anthropometric indices of the children and their mothers were compared, adjusting for changes in household socioeconomic characteristics. | sentnum | 4 | -1 | The results show a decline in the quality of the first complementary foods offered to the infants, i.e. less frequent use of special transitional foods and imported complementary flours (of higher nutritional quality), and preparation of less nutritious local gruels. | sentnum | 5 | -1 | Overall, the nutritional situation had deteriorated, with greater levels of stunting and wasting among children, mothers with lower body mass index, and infants with reduced birth weights. | sentnum | 6 | -1 | Increased food prices would appear to be the direct cause of the decreased quality in complementary feeding, but factors other than the devaluation have also had an impact on household welfare. | sentnum | 7 | -1 | The influence of these factors on nutritional status is discussed. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000100019 | language | EN | section | title | -1 | sentnum | 0 | -1 | Health system reform and the role of field sites based upon demographic and health surveillance. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Field sites for demographic and health surveillance have made well-recognized contributions to the evaluation of new or untested interventions, largely through efficacy trials involving new technologies or the delivery of selected services, e.g. vaccines, oral rehydration therapy and alternative contraceptive methods. | sentnum | 1 | -1 | Their role in health system reform, whether national or international, has, however, proved considerably more limited. | sentnum | 2 | -1 | The present article explores the characteristics and defining features of such field sites in low-income and middle-income countries and argues that many currently active sites have a largely untapped potential for contributing substantially to national and subnational health development. | sentnum | 3 | -1 | Since the populations covered by these sites often correspond with the boundaries of districts or subdistricts, the strategic use of information generated by demographic surveillance can inform the decentralization efforts of national and provincial health authorities. | sentnum | 4 | -1 | Among the areas of particular importance are the following: making population-based information available and providing an information resource; evaluating programmes and interventions; and developing applications to policy and practice. | sentnum | 5 | -1 | The question is posed as to whether their potential contribution to health system reform justifies arguing for adaptations to these field sites and expanded investment in them. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000200003 | language | EN | section | title | -1 | sentnum | 0 | -1 | Safety of immunization injections in Africa: not simply a problem of logistics. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | In 1995, the WHO Regional Office for Africa launched a logistics project to address the four main areas of immunization logistics: the cold chain, transport, vaccine supply and quality, and the safety of injections in the countries of the region. | sentnum | 1 | -1 | The impact of this logistic approach on immunization injection safety was evaluated through surveys of injection procedures and an analysis of the injection materials (e.g. sterilizable or disposable syringes) chosen by the Expanded Programme on Immunization (EPI) and those actually seen to be used. | sentnum | 2 | -1 | Re-use of injection materials without sterilization, accidental needle-stick injuries among health care workers, and injection-related abscesses in patients were common in countries in the WHO African Region. | sentnum | 3 | -1 | Few health centres used time-steam saturation-temperature (TST) indicators to check the quality of sterilization and, in many centres, the injection equipment was boiled instead of being steam sterilized. | sentnum | 4 | -1 | Facilities for the proper disposal of used materials were rarely present. | sentnum | 5 | -1 | Although the official EPI choice was to use sterilizable equipment, use of a combination of sterilizable and disposable equipment was observed in the field. | sentnum | 6 | -1 | Unsafe injection practices in these countries were generally due to a failure to integrate nursing practices and public awareness with injection safety issues, and an absence of the influence of EPI managers on health care service delivery. | sentnum | 7 | -1 | Holistic rather than logistic approaches should be adopted to achieve safe injections in immunization, in the broader context of promoting safe vaccines and safety of all injections. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000200005 | language | EN | section | title | -1 | sentnum | 0 | -1 | Monitoring signals for vaccine safety: the assessment of individual adverse event reports by an expert advisory committee. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Monitoring vaccine safety is a complex and shared responsibility. | sentnum | 1 | -1 | It can be carried out in many ways, one of which is the reporting of individual cases of adverse reactions thought to be due to vaccination. | sentnum | 2 | -1 | The task is difficult because ascribing causality to an individual case report is fraught with challenges. | sentnum | 3 | -1 | A standardized evaluation instrument - known as the causality assessment form - was therefore developed for use by an expert advisory committee to facilitate the process. | sentnum | 4 | -1 | By following the several sections in this form, the members of the committee are taken through series of points to establish causality. | sentnum | 5 | -1 | These points include the basic criteria for causation such as biological plausibility, the time elapsed between the vaccine administration and the onset of the adverse event, and whether other factors (drugs, chemicals or underlying disease) could account for the adverse symptoms. | sentnum | 6 | -1 | The form concludes with consensus assessment of causality, a commentary about the assessment, and advice for further study or follow-up. | sentnum | 7 | -1 | This method of assessing the more serious cases of adverse reaction reported to vaccination has proven useful in evaluating ongoing safety of vaccines in Canada. | sentnum | 8 | -1 | Through analyses such as this, new signals can be identified and investigated further. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000200007 | language | EN | section | title | -1 | sentnum | 0 | -1 | Simian virus 40, poliovirus vaccines, and human cancer: research progress versus media and public interests. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | From 1955 through early 1963, millions of people were inadvertently exposed to simian virus 40 (SV40) as a contaminant of poliovirus vaccines; the virus had been present in the monkey kidney cultures used to prepare the vaccines and had escaped detection. | sentnum | 1 | -1 | SV40 was discovered in 1960 and subsequently eliminated from poliovirus vaccines. | sentnum | 2 | -1 | This article reviews current knowledge about SV40 and considers public responses to reports in the media. | sentnum | 3 | -1 | SV40 is a potent tumour virus with broad tissue tropism that induces tumours in rodents and transforms cultured cells from many species. | sentnum | 4 | -1 | It is also an important laboratory model for basic studies of molecular processes in eukaryotic cells and mechanisms of neoplastic transformation. | sentnum | 5 | -1 | SV40 neutralizing antibodies have been detected in individuals not exposed to contaminated poliovirus vaccines. | sentnum | 6 | -1 | There have been many reports of detection of SV40 DNA in human tumours, especially mesotheliomas, brain tumours and osteosarcomas; and DNA sequence analyses have ruled out the possibility that the viral DNA in tumours was due to laboratory contamination or that the virus had been misidentified. | sentnum | 7 | -1 | However, additional studies are necessary to prove that SV40 is the cause of certain human cancers. | sentnum | 8 | -1 | A recently published review article evaluated the status of the field and received much media attention. | sentnum | 9 | -1 | The public response emphasized that there is great interest in the possibility of health risks today from vaccinations received in the past. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000200014 | language | EN | section | title | -1 | sentnum | 0 | -1 | Directly observed treatment, short-course strategy and multidrug-resistant tuberculosis: are any modifications required?. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Multidrug-resistant tuberculosis (MDRTB) should be defined as tuberculosis with resistance to at least isoniazid and rifampicin because these drugs are the cornerstone of short-course chemotherapy, and combined isoniazid and rifampicin resistance requires prolonged treatment with second-line agents. | sentnum | 1 | -1 | Short-course chemotherapy is a key ingredient in the tuberculosis control strategy known as directly observed treatment, short-course (DOTS). | sentnum | 2 | -1 | For populations in which multidrug-resistant tuberculosis is endemic, the outcome of the standard short-course chemotherapy regimen remains uncertain. | sentnum | 3 | -1 | Unacceptable failure rates have been reported and resistance to additional agents may be induced. | sentnum | 4 | -1 | As a consequence there have been calls for well-functioning DOTS programmes to provide additional services in areas with high rates of multidrug-resistant tuberculosis. | sentnum | 5 | -1 | These ‘‘DOTS-plus for MDRTB programmes’’ may need to modify all five elements of the DOTS strategy: the treatment may need to be individualized rather than standardized; laboratory services may need to provide facilities for on-site culture and antibiotic susceptibility testing; reliable supplies of a wide range of expensive second-line agents would have to be supplied; operational studies would be required to determine the indications for and format of the expanded programmes; financial and technical support from international organizations and Western governments would be needed in addition to that obtained from local governments. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000200016 | language | EN | section | title | -1 | sentnum | 0 | -1 | Preventing trachoma through environmental sanitation: a review of the evidence base. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | A review of the available evidence for the associations between environmental sanitation and transmission of trachoma was undertaken with a view to identifying preventive interventions. | sentnum | 1 | -1 | The WHO Global Alliance for the Elimination of Trachoma by the Year 2020 (GET2020) has adopted the ‘‘SAFE’’ strategy, consisting of four components: Surgery, Antibiotic treatment, promotion of Facial cleanliness and initiation of Environmental changes. | sentnum | 2 | -1 | This review of 19 studies selected from the 39 conducted in different parts of the world shows that there is clear evidence to support the recommendation of facial cleanliness and environmental improvements (i.e. the F and E components of the SAFE strategy) to prevent trachoma. | sentnum | 3 | -1 | Person-to-person contact and flies appear to constitute the major transmission pathways. | sentnum | 4 | -1 | Improvement of personal and community hygiene has great potential for a sustainable reduction in trachoma transmission. | sentnum | 5 | -1 | Controlled clinical trials are needed to estimate the relative contribution of various elements to the risk of transmission of trachoma and the effectiveness of different interventions. | sentnum | 6 | -1 | These could show the relative attributable risks and effectiveness of interventions to achieve improvement of personal hygiene and fly control by environmental improvements, alone or in combination, and with or without antibiotic treatment. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000300003 | language | EN | section | title | -1 | sentnum | 0 | -1 | Disease eradication as a public health strategy: a case study of poliomyelitis eradication. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Disease eradication as a public health strategy was discussed at international meetings in 1997 and 1998. | sentnum | 1 | -1 | In this article, the ongoing poliomyelitis eradication initiative is examined using the criteria for evaluating candidate diseases for eradication proposed at these meetings, which covered costs and benefits, biological determinants of eradicability (technical feasibility) and societal and political considerations (operational feasibility). | sentnum | 2 | -1 | The benefits of poliomyelitis eradication are shown to include a substantial investment in health services delivery, the elimination of a major cause of disability, and far-reaching intangible effects, such as establishment of a culture of prevention'. | sentnum | 3 | -1 | The costs are found to be financial and finite, despite some disturbances to the delivery of other health services. | sentnum | 4 | -1 | The technical' feasibility of poliomyelitis eradication is seen in the absence of a non-human reservoir and the presence of both an effective intervention and delivery strategy (oral poliovirus vaccine and national immunization days) and a sensitive and specific diagnostic tool (viral culture of specimens from acute flaccid paralysis cases). | sentnum | 5 | -1 | The certification of poliomyelitis eradication in the Americas in 1994 and interruption of endemic transmission in the Western Pacific since March 1997 confirm the operational feasibility of this goal. | sentnum | 6 | -1 | When the humanitarian, economic and consequent benefits of this initiative are measured against the costs, a strong argument is made for eradication as a valuable disease control strategy. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000300005 | language | EN | section | title | -1 | sentnum | 0 | -1 | Polio as a platform: using national immunization days to deliver vitamin A supplements. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | In 1988 the 41st World Health Assembly committed WHO to the goal of global eradication of poliomyelitis by 2000 "in ways which strengthen national immunization programmes and health infrastructure". | sentnum | 1 | -1 | The successful use of polio National Immunization Days (NIDs) to deliver vitamin A is an example of how polio eradication can serve as a platform to address other problems of child health. | sentnum | 2 | -1 | Importantly, this integration is helping to achieve the World Summit for Children goal of eliminating vitamin A deficiency by the year 2000. | sentnum | 3 | -1 | It is estimated that between 140 million and 250 million preschool children are at risk of subclinical vitamin A deficiency. | sentnum | 4 | -1 | In 1998 more than 60 million children at risk received vitamin A supplements during polio national immunization days (NIDs). | sentnum | 5 | -1 | While food fortification and dietary approaches are fundamental to combating vitamin A deficiency, the administration of vitamin A supplements during NIDs helps raise awareness, enhance technical capacity, improve assessment and establish a reporting system. | sentnum | 6 | -1 | Moreover, polio NIDs provide an entry point for the sustainable provision of vitamin A supplements with routine immunization services and demonstrate how immunization campaigns can be used for the delivery of other preventive health services. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000300007 | language | EN | section | title | -1 | sentnum | 0 | -1 | Poliomyelitis surveillance: the model used in India for polio eradication. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Poliomyelitis surveillance in India previously involved the passive reporting of clinically suspected cases. | sentnum | 1 | -1 | The capacity for detecting the disease was limited because there was no surveillance of acute flaccid paralysis (AFP). | sentnum | 2 | -1 | In October 1997, 59 specially trained Surveillance Medical Officers were deployed throughout the country to establish active AFP surveillance; 11 533 units were created to report weekly on the occurrence of AFP cases at the district, state and national levels; timely case investigation and the collection of stool specimens from AFP cases was undertaken; linkages were made to support the polio laboratory network; and extensive training of government counterparts of the Surveillance Medical Officers was conducted. | sentnum | 3 | -1 | Data reported at the national level are analysed and distributed weekly. | sentnum | 4 | -1 | Annualized rates of non-polio AFP increased from 0.22 per 100 000 children aged under 15 years in 1997 to 1.39 per 100 000 in 1999. | sentnum | 5 | -1 | The proportion of cases with two adequate stools collected within two weeks of the onset of paralysis increased from 34% in 1997 to 68% in 1999. | sentnum | 6 | -1 | The number of polio cases associated with the isolation of wild poliovirus decreased from 211 in the first quarter of 1998 to 77 in the first quarter of 1999. | sentnum | 7 | -1 | Widespread transmission of wild poliovirus types 1 and 3 persists throughout the country; type 2 occurs only in Bihar and Uttar Pradesh. | sentnum | 8 | -1 | In order to achieve polio eradication in India during 2000, extra national immunization days and house-to-house mopping-up rounds should be organized. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000300010 | language | EN | section | title | -1 | sentnum | 0 | -1 | Stopping poliovirus vaccination after eradication: issues and challenges. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Since 1988 reported polio cases worldwide have declined by about 85% and the number of known or suspected polioendemic countries has decreased from over 120 to less than 50. | sentnum | 1 | -1 | With eradication of poliomyelitis approaching, issues potentially affecting when and how vaccination against poliovirus can be stopped become extremely important. | sentnum | 2 | -1 | Because of the potential risks and benefits inherent in such a decision, the best available science, a risk-benefit analysis, contingency plans, a stock pile of poliovirus vaccines, and the endorsement by the global policy-making committees will all be needed before vaccination can be discontinued. | sentnum | 3 | -1 | The scientific basis for stopping polio immunization has been reviewed by WHO. | sentnum | 4 | -1 | This Round Table article summarizes the current state of knowledge, provides an update on the processes and timelines for certification, containment, and stopping vaccination, and highlights some of the unanswered scientific questions that will be addressed by further research. | sentnum | 5 | -1 | These include whether transmission of vaccine-derived poliovirus strains could be sustained so that poliomyelitis could re-emerge in a future unvaccinated population and whether prolonged excretion of vaccine-derived poliovirus from individuals with immune deficiencies could be a mechanism through which this could occur. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000300014 | language | EN | section | title | -1 | sentnum | 0 | -1 | The role of son preference in reproductive behaviour in Pakistan. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The sex of surviving children is an important determinant of reproductive behaviour in South Asia in general and Pakistan in particular. | sentnum | 1 | -1 | This cohort study evaluates the role of the sex of children on reproductive intentions and subsequent behaviour of women in urban slums of Karachi, Pakistan. | sentnum | 2 | -1 | The analysis is based on two rounds of surveys conducted in 1990-91 and 1995 of a cohort of married women aged 15-49 years. | sentnum | 3 | -1 | The results show that pregnancies became increasingly unwanted as the number of surviving sons increased. | sentnum | 4 | -1 | The sex of surviving children was strongly correlated with subsequent fertility and contraceptive behaviour. | sentnum | 5 | -1 | However, rather than an exclusive son preference, couples strove for one or more sons and at least one surviving daughter. | sentnum | 6 | -1 | The policy implications of the link between overt son preference and low status of women are discussed. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000300016 | language | EN | section | title | -1 | sentnum | 0 | -1 | A proposal to declare neurocysticercosis an international reportable disease. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Neurocysticercosis is an infection of the nervous system caused by Taenia solium. | sentnum | 1 | -1 | It is the most important human parasitic neurological disease and a common cause of epilepsy in Africa, Asia, and Latin America, representing enormous costs for anticonvulsants, medical resources and lost production. | sentnum | 2 | -1 | Neurocysticercosis is a human-to-human infection, acquired by the faecal-enteric route from carriers of intestinal T. solium, most often in areas with deficient sanitation. | sentnum | 3 | -1 | Intestinal tapeworms cause few symptoms, but adult taeniae carried by humans release large numbers of infective eggs and are extremely contagious. | sentnum | 4 | -1 | Ingestion of poorly cooked pig meat infested with T. solium larvae results in intestinal taeniosis but not neurocysticercosis. | sentnum | 5 | -1 | With a view to hastening the control of taeniosis and neurocysticercosis we propose that neurocysticercosis be declared an international reportable disease. | sentnum | 6 | -1 | New cases of neurocysticercosis should be reported by physicians or hospital administrators to their health ministries. | sentnum | 7 | -1 | An epidemiological intervention could then be launched to interrupt the chain of transmission by: (1) searching for, treating and reporting the sources of contagion, i.e. human carriers of tapeworms; (2) identifying and treating other exposed contacts; (3) providing health education on parasite transmission and improvement of hygiene and sanitary conditions; and (4) enforcing meat inspection policies and limiting the animal reservoir by treatment of pigs. | sentnum | 8 | -1 | We believe that the first step required to solve the problem of neurocysticercosis is to implement appropriate surveillance mechanisms under the responsibility of ministries of health. | sentnum | 9 | -1 | Compulsory notification also has the major advantage of providing accurate quantification of the incidence and prevalence of neurocysticercosis at regional level, thus permitting the rational use of resources in eradication campaigns. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000400004 | language | EN | section | title | -1 | sentnum | 0 | -1 | The burden of mental disorders: a comparison of methods between the Australian burden of disease studies and the Global Burden of Disease study. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The national and Victorian burden of disease studies in Australia set out to examine critically the methods used in the Global Burden of Disease study to estimate the burden of mental disorders. | sentnum | 1 | -1 | The main differences include the use of a different set of disability weights allowing estimates in greater detail by level of severity, adjustments for comorbidity between mental disorders, a greater number of mental disorders measured, and modelling of substance use disorders, anxiety disorders and bipolar disorder as chronic conditions. | sentnum | 2 | -1 | Uniform age-weighting in the Australian studies produces considerably lower estimates of the burden due to mental disorders in comparison with age-weighted disability-adjusted life years. | sentnum | 3 | -1 | A lack of follow-up data on people with mental disorders who are identified in cross-sectional surveys poses the greatest challenge in determining the burden of mental disorders more accurately. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000400006 | language | EN | section | title | -1 | sentnum | 0 | -1 | Why does the burden of disease persist? | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Why does the burden of mental disorders persist in established market economies? | sentnum | 1 | -1 | There are four possibilities: the burden estimates are wrong; there are no effective treatments; people do not receive treatment; or people do not receive effective treatments. | sentnum | 2 | -1 | Data from the Australian National Survey of Mental Health and Wellbeing about the two commonest mental disorders, generalized anxiety disorder and depression, have been used in examining these issues. | sentnum | 3 | -1 | The burden of mental disorders in Australia is third in importance after heart disease and cancer, and anxiety and depressive disorders account for more than half of that burden. | sentnum | 4 | -1 | The efficacy of treatments for both disorders has been established. | sentnum | 5 | -1 | However, of those surveyed, 40% with current disorders did not seek treatment in the previous year and only 45% were offered a treatment that could have been beneficial. | sentnum | 6 | -1 | Treatment was not predictive of disorders that remitted during the year. | sentnum | 7 | -1 | The burden therefore persists for two reasons: too many people do not seek treatment and, when they do, efficacious treatments are not always used effectively. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000400009 | language | EN | section | title | -1 | sentnum | 0 | -1 | Mental health policy development in Africa. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Mental health issues are usually given very low priority in health service policies. | sentnum | 1 | -1 | Although this is changing, African countries are still confronted with so many problems caused by communicable diseases and malnutrition that they have not woken up to the impact of mental disorders. | sentnum | 2 | -1 | Every country must formulate a mental health policy based on its own social and cultural realities. | sentnum | 3 | -1 | Such policies must take into account the scope of mental health problems, provide proven and affordable interventions, safeguard patients' rights, and ensure equity. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000400011 | language | EN | section | title | -1 | sentnum | 0 | -1 | Towards a global alcohol policy: alcohol, public health and the role of WHO. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | In 1983 the World Health Assembly declared alcohol-related problems to be among the world's major health concerns. | sentnum | 1 | -1 | Since then, alcohol consumption has risen in developing countries, where it takes a heavy toll. | sentnum | 2 | -1 | Alcohol-related problems are at epidemic levels in the successor states of the Soviet Union and are responsible for 3.5% of disability-adjusted life years (DALYs) lost globally. | sentnum | 3 | -1 | Substantial evidence exists of the relationship between the levels and patterns of alcohol consumption on the one hand and the incidence of alcohol-related problems on the other. | sentnum | 4 | -1 | Over the past 20 years, research has demonstrated the effectiveness of public policies involving, for example, taxation and restrictions on alcohol availability, in reducing alcohol-related problems. | sentnum | 5 | -1 | In the wake of rapid economic globalization, many of these policies at national and subnational levels have been eroded, often with the support of international financial and development organizations. | sentnum | 6 | -1 | Development agencies and international trade agreements have treated alcohol as a normal commodity, overlooking the adverse consequences of its consumption on productivity and health. | sentnum | 7 | -1 | WHO is in a strong position to take the lead in developing a global alcohol policy aimed at reducing alcohol-related problems, providing scientific and statistical support, capacity-building, disseminating effective strategies and collaborating with other international organizations. | sentnum | 8 | -1 | Such leadership can play a significant part in diminishing the health and social problems associated with alcohol use. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000400017 | language | EN | section | title | -1 | sentnum | 0 | -1 | Nutritional status of breastfed infants in rural Zambia: comparison of the National Center for Health Statistics growth reference versus the WHO 12-month breastfed pooled data set. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Cross-sectional data for breastfed infants in rural Zambia were used to evaluate the effect of applying two different data sets as a reference, i.e. the WHO 12-month breastfed pooled data set and the National Center for Health Statistics (NCHS) growth reference in terms of prevalence of malnutrition (stunting, underweight, and wasting). | sentnum | 1 | -1 | A total of 518 infants who were attending mother-and-child health clinics were included. | sentnum | 2 | -1 | Age, weight and length were recorded. | sentnum | 3 | -1 | Anthropometric Z-scores were calculated in two ways: by applying the NCHS growth reference and by using the WHO breastfed data set. | sentnum | 4 | -1 | Anthropometric Z-scores calculated using the breastfed data set were lower during the first 6-7 months of life compared with those calculated by applying the NCHS growth reference. | sentnum | 5 | -1 | This resulted in a higher proportion of children aged 0-6 months being classified as stunted and underweight using the breastfed data set versus the NCHS growth reference. | sentnum | 6 | -1 | After the age of 7 months, similar prevalences of stunting or underweight were observed. | sentnum | 7 | -1 | Relatively few infants were classified as wasted. | sentnum | 8 | -1 | In order to adequately assess the prevalence of stunting and underweight in breastfed infants, it is recommended that a new growth reference be developed, as has been initiated by WHO. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000400019 | language | EN | section | title | -1 | sentnum | 0 | -1 | Global public-private partnerships: part I - a new development in health?. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The proliferation of public-private partnerships is rapidly reconfiguring the international health landscape. | sentnum | 1 | -1 | This article (part I of two on the subject) traces the changing nature of partnership, and discusses the definitional and conceptual ambiguities surrounding the term. | sentnum | 2 | -1 | After defining global public-private partnerships (GPPPs) for health development, we analyse the factors which have led to the convergence of public and private actors and discuss the consequences of the trend toward partnership between UN agencies (including the World Bank) and commercial entities in the health sector. | sentnum | 3 | -1 | Generic factors such as globalization and disillusionment with the UN, and factors specific to the health sector, such as market failure in product development for orphan diseases, are examined. | sentnum | 4 | -1 | Reviewed are the interests, policies, practices and concerns of the UN, the private-for-profit sector, bilateral organizations, and governments of low-income countries with respect to public-private partnership. | sentnum | 5 | -1 | While GPPPs bring much needed resources to problems of international health, we highlight concerns regarding this new organizational format. | sentnum | 6 | -1 | Part II, which will be published in the May issue of the Bulletin, presents a conceptual framework for analysing health GPPPs and explores the issues raised. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000500003 | language | EN | section | title | -1 | sentnum | 0 | -1 | Making abortions safe: a matter of good public health policy and practice. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Globally, abortion mortality accounts for at least 13% of all maternal mortality. | sentnum | 1 | -1 | Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. | sentnum | 2 | -1 | Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. | sentnum | 3 | -1 | This article examines the changes in policy and health service provision required to make abortions safe. | sentnum | 4 | -1 | It is based on a wide-ranging review of published and unpublished sources. | sentnum | 5 | -1 | In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. | sentnum | 6 | -1 | The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. | sentnum | 7 | -1 | Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000500005 | language | EN | section | title | -1 | sentnum | 0 | -1 | Maternal mortality in rural Gambia: levels, causes and contributing factors. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | A demographic study carried out in a rural area of the Gambia between January 1993 and December 1998 recorded 74 deaths among women aged 15-49 years. | sentnum | 1 | -1 | Reported here is an estimation of maternal mortality among these 74 deaths based on a survey of reproductive age mortality, which identified 18 maternal deaths by verbal autopsy. | sentnum | 2 | -1 | Over the same period there were 4245 live births in the study area, giving a maternal mortality ratio of 424 per 100 000 live births. | sentnum | 3 | -1 | This maternal mortality estimate is substantially lower than estimates made in the 1980s, which ranged from 1005 to 2362 per 100 000 live births, in the same area. | sentnum | 4 | -1 | A total of 9 of the 18 deaths had a direct obstetric cause - haemorrhage (6 deaths), early pregnancy (2), and obstructed labour (1). | sentnum | 5 | -1 | Indirect causes of obstetric deaths were anaemia (4 deaths), hepatitis (1), and undetermined (4). | sentnum | 6 | -1 | Low standards of health care for obstetric referrals, failure to recognize the severity of the problem at the community level, delays in starting the decision-making process to seek health care, lack of transport, and substandard primary health care were identified more than once as probable or possible contributing factors to these maternal deaths. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000500007 | language | EN | section | title | -1 | sentnum | 0 | -1 | Perinatal mortality attributable to complications of childbirth in Matlab, Bangladesh. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Very few population-based studies of perinatal mortality in developing countries have examined the role of intrapartum risk factors. | sentnum | 1 | -1 | In the present study, the proportion of perinatal deaths that are attributable to complications during childbirth in Matlab, Bangladesh, was assessed using community-based data from a home-based programme led by professional midwives between 1987 and 1993. | sentnum | 2 | -1 | Complications during labour and delivery - such as prolonged or obstructed labour, abnormal fetal position, and hypertensive diseases of pregnancy - increased the risk of perinatal mortality fivefold and accounted for 30% of perinatal deaths. | sentnum | 3 | -1 | Premature labour, which occurred in 20% of pregnancies, accounted for 27% of perinatal mortality. | sentnum | 4 | -1 | Better care by qualified staff during delivery and improved care of newborns should substantially reduce perinatal mortality in this study population. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000500009 | language | EN | section | title | -1 | sentnum | 0 | -1 | Measuring reproductive health: review of community-based approaches to assessing morbidity. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | This article begins by reviewing selected past approaches to estimating the prevalence of a range of morbidities through the use of household or community-based interview surveys in developed and developing countries. | sentnum | 1 | -1 | Subsequently, it reviews epidemiological studies that have used a range of methods to estimate the prevalence of reproductive morbidities. | sentnum | 2 | -1 | A detailed review of recent community or hospital based health interview validation studies that compare self-reported, clinical and laboratory measures is presented. | sentnum | 3 | -1 | Studies from Bangladesh, Bolivia, China, Egypt, India, Indonesia, Nigeria, Philippines and Turkey provide empirical evidence that self-reported morbidity and observed morbidity measure different phenomena and therefore different aspects of reproductive health and illness. | sentnum | 4 | -1 | Rather than estimating the prevalence of morbidity, interview-based surveys may provide useful information about the disability or burden associated with reproductive health and illness. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000500011 | language | EN | section | title | -1 | sentnum | 0 | -1 | Health sector reform and reproductive health in Latin America and the Caribbean: strengthening the links. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. | sentnum | 1 | -1 | Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex, competing, and political nature of health sector reform and reproductive health. | sentnum | 2 | -1 | The objectives of reproductive health care can run parallel to those of health sector reform in that both are concerned with promoting equitable access to high quality care by means of integrated approaches to primary health care, and by the involvement of the public in setting health sector priorities. | sentnum | 3 | -1 | However, there is a serious risk that health reforms will be driven mainly by financial and/or political considerations and not by the need to improve the quality of health services as a basic human right. | sentnum | 4 | -1 | With only limited changes to the health systems in many Latin American and Caribbean countries and a handful of examples of positive progress resulting from reforms, the gap between rhetoric and practice remains wide. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000500014 | language | EN | section | title | -1 | sentnum | 0 | -1 | Antibody response of patients after postexposure rabies vaccination with small intradermal doses of purified chick embryo cell vaccine or purified Vero cell rabies vaccine. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Although the introduction of tissue culture vaccines for rabies has dramatically improved the immunogenicity and safety of rabies vaccines, they are often prohibitively expensive for developing countries. | sentnum | 1 | -1 | To examine whether smaller doses of these vaccines could be used, we tested the safety and immunogenicity of purified chick embryo cell vaccine (PCECV) on 211 patients in Thailand with World Health Organization (WHO) category II and III exposures to rabies. | sentnum | 2 | -1 | The patients presented at two Thai hospitals and were randomized into three groups. | sentnum | 3 | -1 | Patients in Group 1 received 0.1 ml PCECV intradermally at two sites on days 0, 3, 7, and at one site on days 30 and 90. | sentnum | 4 | -1 | Group 2 was treated similarly, except that purified Vero cell rabies vaccine (PVRV) was used instead of PCECV. | sentnum | 5 | -1 | Group 3 received 1.0 ml PCECV intramuscularly on days 0, 3, 7, 14, 30 and 90. | sentnum | 6 | -1 | After 0, 3, 7, 14, 30 and 90 days serum was collected from the subjects and the geometric mean titres (GMTs) of rabies virus neutralizing antibody determined. | sentnum | 7 | -1 | After 14 days the GMT of 59 patients vaccinated intradermally with PCECV was equivalent to that of patients who received PVRV. | sentnum | 8 | -1 | Adverse reactions were more frequent in patients who received vaccines intradermally, indicating the reactions were associated with the route of injection, rather than the vaccine per se. | sentnum | 9 | -1 | We conclude that PCECV is a safe and highly immunogenic vaccine for postexposure rabies vaccination when administered intradermally in 0.1-ml doses using the two-site method (2,2,2,0,1,1') recommended by WHO. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000600004 | language | EN | section | title | -1 | sentnum | 0 | -1 | A framework for assessing the performance of health systems. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. | sentnum | 1 | -1 | This paper proposes a framework to advance the understanding of health system performance. | sentnum | 2 | -1 | A first step is to define the boundaries of the health system, based on the concept of health action. | sentnum | 3 | -1 | Health action is defined as any set of activities whose primary intent is to improve or maintain health. | sentnum | 4 | -1 | Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. | sentnum | 5 | -1 | Improving health means both increasing the average health status and reducing health inequalities. | sentnum | 6 | -1 | Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). | sentnum | 7 | -1 | Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). | sentnum | 8 | -1 | This implies that everyone is protected from financial risks due to health care. | sentnum | 9 | -1 | The measurement of performance relates goal attainment to the resources available. | sentnum | 10 | -1 | Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). | sentnum | 11 | -1 | By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance, but also to contemplate major policy challenges. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000600006 | language | EN | section | title | -1 | sentnum | 0 | -1 | Benchmarks of fairness for health care reform: a policy tool for developing countries. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Teams of collaborators from Colombia, Mexico, Pakistan, and Thailand have adapted a policy tool originally developed for evaluating health insurance reforms in the United States into "benchmarks of fairness" for assessing health system reform in developing countries. | sentnum | 1 | -1 | We describe briefly the history of the benchmark approach, the tool itself, and the uses to which it may be put. | sentnum | 2 | -1 | Fairness is a wide term that includes exposure to risk factors, access to all forms of care, and to financing. | sentnum | 3 | -1 | It also includes efficiency of management and resource allocation, accountability, and patient and provider autonomy. | sentnum | 4 | -1 | The benchmarks standardize the criteria for fairness. | sentnum | 5 | -1 | Reforms are then evaluated by scoring according to the degree to which they improve the situation, i.e. on a scale of -5 to 5, with zero representing the status quo. | sentnum | 6 | -1 | The object is to promote discussion about fairness across the disciplinary divisions that keep policy analysts and the public from understanding how trade-offs between different effects of reforms can affect the overall fairness of the reform. | sentnum | 7 | -1 | The benchmarks can be used at both national and provincial or district levels, and we describe plans for such uses in the collaborating sites. | sentnum | 8 | -1 | A striking feature of the adaptation process is that there was wide agreement on this ethical framework among the collaborating sites despite their large historical, political and cultural differences. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000600008 | language | EN | section | title | -1 | sentnum | 0 | -1 | Benchmarks for health expenditures, services and outcomes in Africa during the 1990s. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | There is limited information on national health expenditures, services, and outcomes in African countries during the 1990s. | sentnum | 1 | -1 | We intend to make statistical information available for national level comparisons. | sentnum | 2 | -1 | National level data were collected from numerous international databases, and supplemented by national household surveys and World Bank expenditure reviews. | sentnum | 3 | -1 | The results were tabulated and analysed in an exploratory fashion to provide benchmarks for groupings of African countries and individual country comparison. | sentnum | 4 | -1 | There is wide variation in scale and outcome of health care spending between African countries, with poorer countries tending to do worse than wealthier ones. | sentnum | 5 | -1 | From 1990-96, the median annual per capita government expenditure on health was nearly US$ 6, but averaged US$ 3 in the lowest-income countries, compared to US$ 72 in middle-income countries. | sentnum | 6 | -1 | Similar trends were found for health services and outcomes. | sentnum | 7 | -1 | Results from individual countries (particularly Ethiopia, Ghana, Côte d'Ivoire and Gabon) are used to indicate how the data can be used to identify areas of improvement in health system performance. | sentnum | 8 | -1 | Serious gaps in data, particularly concerning private sector delivery and financing, health service utilization, equity and efficiency measures, hinder more effective health management. | sentnum | 9 | -1 | Nonetheless, the data are useful for providing benchmarks for performance and for crudely identifying problem areas in health systems for individual countries. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000600010 | language | EN | section | title | -1 | sentnum | 0 | -1 | Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. | sentnum | 1 | -1 | With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. | sentnum | 2 | -1 | Empirical evidence from actual production modalities is also taken into consideration. | sentnum | 3 | -1 | We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. | sentnum | 4 | -1 | In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). | sentnum | 5 | -1 | These valuable resources are often ignored by the public sector. | sentnum | 6 | -1 | The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. | sentnum | 7 | -1 | Subsidiary activities within the production process can often be unbundled and outsourced. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000600012 | language | EN | section | title | -1 | sentnum | 0 | -1 | The role of the hospital in a changing environment. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Hospitals pose many challenges to those undertaking reform of health care systems. | sentnum | 1 | -1 | This paper examines the evolving role of the hospital within the health care system in industrialized countries and explores the evidence on which policy-makers might base their decisions. | sentnum | 2 | -1 | It begins by tracing the evolving concept of the hospital, concluding that hospitals must continue to evolve in response to factors such as changing health care needs and emerging technologies. | sentnum | 3 | -1 | The size and distribution of hospitals are matters for ongoing debate. | sentnum | 4 | -1 | This paper concludes that evidence in favour of concentrating hospital facilities, whether as a means of enhancing effectiveness or efficiency, is less robust than is often assumed. | sentnum | 5 | -1 | Noting that care provided in hospitals is often less than satisfactory, this paper summarizes the evidence underlying three reform strategies: (i) behavioural interventions such as quality assurance programmes; (ii) changing organizational culture; and (iii) the use of financial incentives. | sentnum | 6 | -1 | Isolated behavioural interventions have a limited impact, but are more effective when combined. | sentnum | 7 | -1 | Financial incentives are blunt instruments that must be monitored. | sentnum | 8 | -1 | Organizational culture, which has previously received relatively little attention, appears to be an important determinant of quality of care and is threatened by ill-considered policies intended to 're-engineer' hospital services. | sentnum | 9 | -1 | Overall, evidence on the effectiveness of policies relating to hospitals is limited and this paper indicates where such evidence can be found. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000600014 | language | EN | section | title | -1 | sentnum | 0 | -1 | The use of private-sector contracts for primary health care: theory, evidence and lessons for low-income and middle-income countries. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. | sentnum | 1 | -1 | This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and governments to manage them. | sentnum | 2 | -1 | This review highlights theories and evidence relating to contracts for primary health care services and examines their implications for contractual relationships in low- and middle-income countries. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000700003 | language | EN | section | title | -1 | sentnum | 0 | -1 | Tobacco use by youth: a surveillance report from the Global Youth Tobacco Survey project. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The Global Youth Tobacco Survey (GYTS) project was developed by the World Health Organization and the US Centers for Disease Control and Prevention to track tobacco use among youth in countries across the world, using a common methodology and core questionnaire. | sentnum | 1 | -1 | The GYTS is school based and employs a two-stage sample design to produce representative data on smoking among students aged 13-15 years. | sentnum | 2 | -1 | The first stage consists of a probabilistic selection of schools, and the second consists of a random selection of classes from the participating schools. | sentnum | 3 | -1 | All students in the selected classes are eligible for the survey. | sentnum | 4 | -1 | In 1999, the GYTS was conducted in 13 countries and is currently in progress in over 30 countries. | sentnum | 5 | -1 | This report describes data from 12 countries: Barbados, China, Costa Rica, Fiji, Jordan, Poland, the Russian Federation (Moscow), South Africa, Sri Lanka, Ukraine (Kiev), Venezuela, and Zimbabwe. | sentnum | 6 | -1 | The findings show that tobacco use in the surveyed age group ranged from a high of 33% to a low of 10%. | sentnum | 7 | -1 | While the majority of current smokers wanted to stop smoking, very few were able to attend a cessation programme. | sentnum | 8 | -1 | In most countries the majority of young people reported seeing advertisements for cigarettes in media outlets, but anti-tobacco advertising was rare. | sentnum | 9 | -1 | The majority of young people reported being taught in school about the dangers of smoking. | sentnum | 10 | -1 | Environmental tobacco smoke exposure was very high in all countries. | sentnum | 11 | -1 | These results show that the GYTS surveillance system is enhancing the capacity of countries to design, implement, and evaluate tobacco prevention and control programmes. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000700005 | language | EN | section | title | -1 | sentnum | 0 | -1 | Building the evidence base for global tobacco control. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The tobacco control movement needs a global information system permitting routine monitoring of the tobacco trade, tobacco farming, the tobacco industry, the prevalence of tobacco use, associated mortality, and national resources for combating tobacco. | sentnum | 1 | -1 | The Tobacco Control Country Profiles database, a data collection initiative led by the American Cancer Society in collaboration with WHO and the Centers for Disease Control and Prevention, represents the first step in the development of such a system. | sentnum | 2 | -1 | Baseline data on several indicators of tobacco use were obtained from 191 Member States of WHO, two Associate Members, Hong Kong Special Administrative Region of China (Hong Kong SAR), China (Province of Taiwan) and the West Bank and Gaza Strip. | sentnum | 3 | -1 | The methods used to compile the data are described in the present paper. | sentnum | 4 | -1 | Selected indicators from the database were analysed in order to demonstrate the potential utility and value of data derived from an information system devoted to tobacco control. | sentnum | 5 | -1 | The analyses covered gender-specific smoking prevalence by WHO Region, per capita cigarette consumption by Human Development Index (HDI) category, and average real annual percentage changes in cigarette prices between 1990 and 1999 for selected countries in each category. | sentnum | 6 | -1 | In 1998, men were almost four times more likely than women to be smokers. | sentnum | 7 | -1 | The prevalence of smoking among men was highest in the Western Pacific Region. | sentnum | 8 | -1 | The differential in gender-specific smoking prevalence was narrowest in the Region of the Americas and the European Region. | sentnum | 9 | -1 | It was wider in the South-East Asia Region and the Western Pacific Region. | sentnum | 10 | -1 | The lowest and highest per capita consumption of manufactured cigarettes occurred in the lowest and highest HDI categories respectively. | sentnum | 11 | -1 | In the medium HDI category, China's growing cigarette consumption after 1975 had a major bearing on the rise in per capita consumption. | sentnum | 12 | -1 | Cigarette price trends suggest that there is considerable scope for increasing taxes on tobacco products, particularly in low or medium HDI countries. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
S0042-96862000000700007 | language | EN | section | title | -1 | sentnum | 0 | -1 | Tobacco industry tactics for resisting public policy on health. | language | EN | section | abstract | -1 | sentnum | 0 | -1 | The tactics used by the tobacco industry to resist government regulation of its products include conducting public relations campaigns, buying scientific and other expertise to create controversy about established facts, funding political parties, hiring lobbyists to influence policy, using front groups and allied industries to oppose tobacco control measures, pre-empting strong legislation by pressing for the adoption of voluntary codes or weaker laws, and corrupting public officials. | sentnum | 1 | -1 | Formerly secret internal tobacco industry documents provide evidence of a 50-year conspiracy to resist smoking restrictions, restore smoker confidence and preserve product liability defence'. | sentnum | 2 | -1 | The documents reveal industry-wide collusion on legal, political and socially important issues to the tobacco industry and clearly demonstrate that the industry is not disposed to act ethically or responsibly. | sentnum | 3 | -1 | Societal action is therefore required to ensure that the public health takes precedence over corporate profits. | sentnum | 4 | -1 | Recommendations for reducing the political influence of the tobacco industry include the following. | sentnum | 5 | -1 | Every tobacco company in every market should publicly disclose what it knew about the addictiveness and harm caused by tobacco, when it obtained this information, and what it did about it. | sentnum | 6 | -1 | The industry should be required to guarantee internationally recognized basic consumer rights to its customers. | sentnum | 7 | -1 | Trade associations and other industry groupings established to deceive the public should be disbanded. | sentnum | 8 | -1 | These recommendations should be incorporated into WHO's Framework Convention on Tobacco Control. | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null | null |
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