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[Medico-social prevention, fertility, and development] Prevention medico-sociale, fecondite et developpement.
REVUE TUNISIENNE DE SCIENCES SOCIALES. 1986; 23(84-87):423-510.The author reports on a sample survey of 738 Tunisians, conducted to investigate the impact of preventive and social medicine on health and fertility. The sample population, drawn from the 1975 census, is described. Attention is given to the role played by information sources, particularly mass media, in preventive medicine, alcoholism and the prevention of traffic accidents, and public opinion concerning preventive medicine. Attitudes toward family planning are mentioned in the final section, and a copy of the questionnaire used is included. (ANNOTATION)
WORLD HEALTH FORUM. 1986; 7(2):165.The Expanded Program on Immunization has proved to be the most cost-effective public health scheme yet undertaken in Nigeria, as it costs very much less to prevent diphteria, pertussis, tetanus, measles, poliomyelitis and tuberculosis than it does to cure them. About US$5 are sufficient to fully immunize a child against all these diseases, allowing for a nurse's salary, vaccines, syringes, cold chain equipment, and all other items. This is about 5% of the cost of treating a child with any one of the diseases (and the child could still die). It is quite possible to achieve a high level of immunization initially, but maintaining a satisfactory level is more difficult. Consistent government support, and public awareness of the importance of immunization, are vital for the success of any immunization scheme. Because the attitudes and understanding of mothers to immunization are crucial, we interviewed 575 women of childbearing age in Bendel State, 320 of whom had failed to complete or had not even started the immunization of their children. The replies of the latter group (in table) show that for maximum gains to be made from the Expanded Program on Immunization, which receives strong financial support from the Nigerian authorities, as well as from the WHO and the UN Children's Fund, community education and the mobilization of mothers have to be stepped up. This becomes even more obvious when it is realized that the women in this study had received some form of health education in antenatal clinics, infant welfare clinics, general practice clinics, and immunization centers. This group represents less than 25% of women of childbearing age in Nigeria: over 75% in most rural areas and in improverished urban areas have no access to modern health facilities. Consequently, there is a need to create and sustain public and official support, and to induce a widespread demand for immunization. (full text)
Beverly Hills, California, Sage Publications, 1980. 246 p. (Sage Library of Social Research Vol. 100)This book's objective is to describe the circumstances surrounding adolescent pregnancy, demonstrate the need for social support, and describe how these supports might be offered. It contains 2 basic thrusts. The early chapters describe the adolescent pregnancy problem and the parallels between the development of the adolescent pregnancy and the potential child maltreater. What follows from this description is the author's sense of methods which will help to reduce the risks generated by participation in either, or both, of these environments. The information presented in this volume suggests that the time for joint study of child maltreatment and adolescent pregnancy has arrived. The demand for correlational study of these 2 social situations is viable for 4 interrelated reasons: both child maltreatment and adolescent pregnancy are social phenomena which demonstrate a dramatic increase in reported incidence in the past 25 years; both child maltreaters and adolescents who have experienced pregnancy appear to share multiple demographic or situational variables, i.e., minority overrepresentation, low income, low education, and high unemployment; the development of the maltreating event and the adolescent pregnancy reveal an unusual similarity, and the intergenerational aspects of both problems could well be strongly related to the snowball effect that these problems have on each other; and if the problems of child maltreatment and adolescent pregnancy are found to be symbiotic in their support of each other, rather than independent responses to a uniform social context, the direction of prevention efforts in these 2 areas could produce beneficial reductions in the rates of both problems. The best hope for the provision of prevention services in adolescent pregnancy rests within an alteration in public fears and misconceptions related to welfare dependency, contraceptive use, sexual education and information, and possibly even a general view of the adolescent in society. There is no question that contraceptive programming for the adolescent can serve as a vital preventive measure. The cornerstone of this service returns the perspective to education. Preventive services must include education for contraception, education for appropriate decision making, and education for survival of a parent and child. The community-based multidisciplinary system for the adolescent pregnancy or parent has been demonstrated to be the most effective model for programming today. It is also the most difficult program to find or or develop. Services to adolescents must begin as soon as community standards will permit them to be initiated to prevent the occurrence of the problem. Only when a collage of services in the prevention, treatment, and rehabilitation realms is available for the individual adolescent can it be said that a meaningful program exists.
Medical Anthropology. 1985 Winter; 9(1):49-56.In order to make health services more accessible at the village level, the State of Karnataka began a Primary Health Care (PHC) Program involving Health Guides (HGs). These are local villagers who are trained in basic health services and who work in their own village. This research was conducted among village community members living in the Mysore District, where HGs had been working for 1 year. A total of 240 household members were interviewed using pretested, semi-structured survey instruments in 30 selected villages. Results indicate that 70% of the household members surveyed were aware of the HG scheme, and 58% said the HG was always or often available to them. According to the official guidelines set down by the State of Karnataka, the village community was requested to recommend 2 or 3 persons considered suitable by them to become HG candidates. However, survey results indicate that 99.6% had not been involved in the selection process in any way. When asked what the 4 most important functions of the HGs were, the household members responded overwhelmingly (98.3%) that the sole function was treating minor ailments. More of the household members surveyed went to the HGs to receive medical services than to any other persons. Of those who made HG contact, 52.2% reported that they were very satisfied and 44.4% said they had been partially satisfied by the medical services they had received. The vast majority of the community reported that they felt very little work was being done in the area of prevention (soakage pits, sanitary latrines, water supply, family planning and immunization). But these items were not perceived to be very important and seem to have little impact on the community's acceptance of the HG scheme and on its further continuation and expansion. A large majority of those interviewed wanted the HGs to visit their homes more often for health-related services. 20% of the community household members said they would be in favor of financing the HG honorarium or the HG drug supply, currently provided by the Government of India and the State of Karnataka. Finally, 92.1% felt the HG scheme should be continued in their area and 91.7% felt it should be expanded to other areas of the State. Suggestions are offered regarding ways to improve the community participation in this pilot area. Examples include regular home vistis by the HGs to all households using complete up-to-date household surveys; pictorial signs aroung the village area to advertise HG services; spending more time during training sessions on preventive aspects of the HG job and the adequate explanation of the philosophy of the HG scheme, with particular stress on the importance of preventive and promotive services. Such steps will ensure relevancy of the programs, ensure success of immediate activities, and pave the way for long-term changes in the communities themselves.
Family Planning Perspectives. 1982 Nov/Dec; 14(6):321-4.For 10 years, family planning groups have been trying to persuade the TV and radio industry that advertising nonprescriptive contraceptives would be an effective way to prevent unwanted pregnancies and the spread of venereal diseases, particularly among teenagers. Although formal restrictions on advertising contraceptives have been removed, the networks and most local radio and TV stations still ban commercials for contraceptive products. At a time when many consumers are concerned about health risks associated with the pill and the IUD, manufacturers of condoms, foams and jellies are not motivated to pursue expensive advertising campaigns. Of the stations polled, those with audiences mainly of the age group 18 to 34 are more likely to accept contraceptive advertisement than stations with an older audience. 50% of the stations polled would not air any such ads. Most broadcasters express concern about the quality of the ads if they were used and believe that their audience does not favor them. Few people questioned believe that such an advertising campaign would have much effect on sexual activity, venereal disease or pregnancies. The National Association of Broadcasters' survey reveals that by a margin of 53 to 41%, adults oppose broadcasting contraceptive commercials. Responses indicate that TV ads are less acceptable than radio advertising. Younger adults are more likely to favor ads than older persons. Single people also favor the contraceptive commercials. Less separated or divorced people and even fewer married or widowed people find such ads acceptable. 45% of men and only 35% of women support the advertisments. 40% of whites, 50% blacks and 66% Hispanics think that contraceptive commercials should be aired.