The role of domestic factors and day-care attendance on lung function of primary school children.
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The results of studies examining the relationship of domestic factors to lung function are contradictory. We therefore examined the independent effects of maternal smoking during pregnancy, exposure to environmental tobacco smoke (ETS), the presence of a cat, type of heating and cooking used in the home and day-care attendance on lung function after controlling for socioeconomic status (SES). Nine hundred and eighty-nine children from 18 Montreal schools were studied between April 1990 and November 1992. Information on the child's health and exposure to domestic factors was collected by questionnaire. Spirometry was performed at school. The data were analysed by multiple linear regression with percent predicted FEV1, FVC, and FEV1/FVC as dependent variables. In the overall sample (both sexes combined), cat in the home (regression coefficient, beta = -1.15, 95% confidence interval, CI: -2.26-(-)0.05) and electric baseboard units (beta = -1.26, 95% CI: -2.39-(-)0.13) were independently associated with a lower FEV1/FVC, while day-care attendance (beta = -2.05, 95% CI: -3.71-(-)0.40) significantly reduced FEV1. Household ETS was significantly associated with increasing level of FVC (beta = 2.86, 95% CI: +0.55 to +5.17). In boys but not girls, household ETS (beta = -2.13, 95% CI: -4.07-(-)0.19) and the presence of a cat (beta = -2.19, 95% CI: -3.94-(-)0.45) were associated with lower FEV1/FVC. By contrast, day-care attendance was associated with lower FEV1 (beta = -2.92, 95% CI: -5.27-(-)0.56) and FEV1/FVC (beta = -1.53, 95% CI: -2.73-(-)0.33) in girls only. In conclusion, the results provide evidence that domestic factors and day-care attendance primarily affected airway caliber and gender differences were apparent in the effects of these factors. (+info)
A management information system for nurse/midwives.
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The experiences of nurse/midwives with a simple management information system in the private sector are reported from four facilities in Nigeria. When such a system is being introduced, special attention should be given to strengthening the ability of health workers to record and collate data satisfactorily. (+info)
Developing communality: family-centered programs to improve children's health and well-being.
(3/1572)
Despite decades of enormous investment in research and public programs, the United States continues to face pandemics of preventable health problems such as low birth weight, teenage pregnancy, drug abuse, and interpersonal violence. With some justification, these problems have been blamed on the failings of families. The reasons why families may function poorly in their child-rearing roles have not been coherently or vigorously addressed by our social policies; sometimes these policies have aggravated the problems. This paper provides background to allow a better understanding of families' role in the social determination of children's health, and argues for programs and policies that assist families through the creation of social supports embedded in communities that are characterized by trust and mutual obligation. (+info)
The determinants of infant and child mortality in Tanzania.
(4/1572)
This paper investigates the determinants of infant and child mortality in Tanzania using the 1991/92 Tanzania Demographic and Health Survey. A hazards model is used to assess the relative effect of the variables hypothesized to influence under-five mortality. Short birth intervals, teenage pregnancies and previous child deaths are associated with increased risk of death. The Government of the United Republic of Tanzania should therefore maintain its commitment to encouraging women to space their births at least two years apart and delay childbearing beyond the teenage years. Further, this study shows that there is a remarkable lack of infant and child mortality differentials by socioeconomic subgroups of the population, which may reflect post-independence health policy and development strategies. Whilst lack of socioeconomic differentials can be considered an achievement of government policies, mortality remains high so there is still a long way to go before Tanzania achieves its stated goal of 'Health for All'. (+info)
Childcare needs of female street vendors in Mexico City.
(5/1572)
This article reports on strategies developed by female street vendors (vendedoras ambulantes) in Mexico City to ensure the care of their young children in the absence of a specific and operational government policy to fulfil this need. The information concerning child care and health was gathered by a survey of 426 street traders selected by multi-stage random cluster sampling in four of the administrative districts (delegaciones politicas) of Mexico City during 1990. It was found that, as mothers of young children, street vendors most frequently looked after their children personally on the street or left them with other members of the family. Related factors were availability of alternative child care providers in the family, the age of the children and working conditions of the mother. Children who remained on the streets with their mothers suffered more frequently from gastro-intestinal diseases and accidents than the national average. The incidence of acute respiratory diseases, however, was similar in the cases of maternal care in the street and care by family members in another environment. Existing public health measures show a greater concern for the health of food consumers than that of workers in this area. Current public policy seeks to regulate street vending activities and to concentrate traders in ad hoc areas and facilities. Our research results document the need for actions that can contribute to an improvement in the care and health conditions of these young children. (+info)
Dirt and diarrhoea: formative research in hygiene promotion programmes.
(6/1572)
Investment in the promotion of better hygiene for the prevention of diarrhoeal diseases and as a component of water and sanitation programmes is increasing. Before designing programmes capable of sustainably modifying hygiene behaviour in large populations, valid answers to a number of basic questions concerning the site and the intended beneficiaries have to be obtained. Such questions include 'what practices favour the transmission of enteric pathogens?', 'what advantages will be perceived by those who adopt safe practices?' and 'what channels of communication are currently employed by the target population?' A study of hygiene and diarrhoea in Bobo-Dioulasso, Burkina Faso, used a mixture of methods to address such questions. This paper draws on that experience to propose a plan of preliminary research using a variety of techniques which could be implemented over a period of a few months by planners of hygiene promotion programmes. The techniques discussed include structured observation, focus group discussions and behavioural trials. Modest investment in such systematic formative research with clear and limited goals is likely to be repaid many times over in the increased effectiveness of hygiene promotion programmes. (+info)
The census-based, impact-oriented approach: its effectiveness in promoting child health in Bolivia.
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This paper describes the effectiveness for child health of a primary health care approach developed in Bolivia by Andean Rural Health Care and its colleagues, the census-based, impact-oriented (CBIO) approach. Here, we describe selected achievements, including child survival service coverage, mortality impact, and the level of resources required to attain these results. As a result of first identifying the entire programme population through visits at least biannually to all homes and then targeting selected high-impact services to those at highest risk of death, the mortality levels of children under five years of age in the established programme areas was one-third to one-half of mortality levels in comparison areas. Card-documented coverage for the complete series of all the standard six childhood immunizations among children 12-23 months of age was 78%, and card-documented coverage for three nutritional monitorings during the previous 12 months among the same group of children was 80%. Coverage rates in comparison areas for similar services was less than 21%. The local annual recurring cost of this approach was US $8.57 for each person (of all ages) in the programme population. This cost includes the provision of primary care services for all age groups as well as targeted child survival services. This cost is well within the affordable range for many, if not most, developing countries. Manpower costs for field staff in Bolivia are relatively high, so in countries with lower salary scales, the overall recurring cost could be substantially less. An Expert Review Panel reviewed the CBIO approach and found it to be worthy of replication, particularly if stronger community involvement and greater reliance on volunteer or minimally paid staff could be attained. The results of this approach are sufficiently promising to merit implementation and evaluation in other sites, including sites beyond Bolivia. (+info)
Injury control strategies: extending the quality and quantity of data relating to road traffic accidents in children.
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This review describes how an extended database of information can provide the opportunity to go beyond the traditionally distinct health, engineering, and education initiatives in order to identify the effectiveness of more overarching policies for injury control. Such information can be used to raise awareness and to encourage community participation in designing a road traffic accident prevention strategy. (+info)