Objectives and methods of a world health survey

Many developing countries are trying to improve the routine collection of health information by strengthening surveys, censuses, and registration systems. At the international level, too, efforts are underway to provide information on health and health interventions, including statistical reporting programs of the U.N. and the World Bank. In view of the limited financial resources in the developing countries, would a world health survey complement these health information systems and contribute to long-term health care? This paper finds that although a series of coordinated country health studies could be valuable, there are many tradeoffs. Considering the variety of health problems and priorities in developing countries, it is probably more important to develop the expertise to conduct and analyze health studies than to devise a standard questionnaire to collect health data. As for the cost effectiveness of health programs, a world health survey is not the appropriate vehicle for such evaluations, but it could address such concerns as access, coverage, patient costs, and financing systems.Health Monitoring&Evaluation,Health Systems Development&Reform,Agricultural Knowledge&Information Systems,Housing&Human Habitats,Gender and Health

Impact of cooperative membership on farmers' uptake of technological innovations in Southwest Nigeria

Open access journalThe underutilization of agriculture in Nigeria with attendant low yield per hectare is generally attributed to lack of innovation to cope with the challenges of climate change and land degradation. In this study, using information from 326 farmers in Southwest Nigeria, we examined the relative impact of cooperative membership compared with the effects of other socio- economic factors on farmers’ adoption of technological innovations. Cooperative membership has a high impact compared to other socioeconomic factors such as land access, gender, and educational status. It is recommended that intervention programs in the agricultural sector should focus more attention on strengthening and expanding farmers’ cooperatives for better diffusion and use intensity of innovations and better linking social capital with extension agencies, banks, markets, and agricultural value chains

Institutional barriers to successful innovations: perceptions of rural farmers and key stakeholders in southwest Nigeria

Diffusion studies in sub-Saharan Africa have typically focused on the impact of traditional adoption factors on uptake of technological innovations. This study draws on semi-structured interviews of rural farmers and in-depth interviews of stakeholders in southwest Nigeria to examine the impact of institutional factors on the success of technological innovations. The findings indicate that government policies, markets, financial institutions, infrastructure and other institutional conditions play significant role on the success of technological innovations. A successful innovation package should integrate institutional reforms with promotion of innovative inputs, and vibrant farmers’ cooperatives can be at the heart of such agrarian reform

Farmers’ mobilisation of social capital for beneficial uptake of technological innovations in southwest Nigeria

Social capital has been identified as an important factor influencing successful uptake of technological innovations among small-scale, rural farmers in developing countries. This study draws on descriptive statistics and regression analysis of data obtained from 325 farmers in southwest Nigeria to examine the effectiveness of social capital mobilised by rural farmers. The results indicate farmers’ cooperatives are, because of their stronger organisational capacity and formal structure, able to generate more effective social capital for information sharing and linking up with important external organisations providing technical and financial support for successful adoption of innovations

An intra-community profile of nutritional deficiency: a study of under-fives in a low-income community in Rio de Janeiro (Brazil)

Como parte de um estudo epidemiológico sobre a saúde de crianças abaixo de cinco anos realizado na favela da Rocinha, Rio de Janeiro, RJ (Brasil), avaliou-se o perfil nutricional de uma amostra representativa de 591 crianças. De acordo com o indicador peso-para-idade, 23,9% encontravam-se com desnutrição leve (grau I pela classificação de Gomez), e apenas 22,0% evidenciaram desnutrição moderada (grau II). Esse achado mostrou-se compatível com aqueles onde se utilizaram os indicadores peso-para-altura e altura-para-idade: (a) ausência de desnutrição aguda, com um perfil de peso-para-altura superposto ao de uma população padrão normal, e (b) deficiência de crescimento, com 7% e 15% de crianças excedendo os valores abaixo de, respectivamente, -2 e -1 desvios-padrão esperados numa população normal. Quanto à deficiência estatural, as seguintes variáveis mostraram-se associadas mesmo após controle pelo "status" econômico (indicado pelas condições ambientais do domicílio): baixo peso-ao-nascer, número de irmãos igual ou acima de três, sexo masculino, história de nunca ter amamentado ao seio materno, e história de morte infantil prévia na família. Cada variável é discutida separadamente, bem como o perfil nutricional geral e a marcada estratificação social intracomunitária da deficiência estatural.This study is part of a larger epidemiological study concerned with the health status of children under the age of five carried out in the squatter settlement of Rocinha, and focuses on the nutritional profile of a representative sample of 591 children. According to the weight-for-age criteria (Gomez's classification), 23,9% and 2,0% were, respectively, mildly and moderately malnourished. This finding is in agreement with the assessment using weight-for-height and height-for-age as anthropometric indicators: (a) absence of acute malnutrition (wasting) indicated by a pattern overlapping that of an expected normal population, and (b) growth deficiency (stunting) indicated by 7% and 15% of children exceeding the proportion normally expected to be, respectively, below the -1 and -2 standard deviate limits. So far as growth failure was concerned, the following variables remained associated even when controlling for economic status (indicated by the environmental conditions of the household): low birth weight, number of siblings equal to or above three, male gender, a history of never having breastfed and a family history of previous sibling death. Each variable is discussed separately, as well as the overall nutritional profile and the marked social intra-community stratification related to growth deficit

Urban Family Planning in Low- and Middle-Income Countries: A Critical Scoping Review

Health agendas for low- and middle-income countries (LMICs) should embrace and afford greater priority to urban family planning to help achieve a number of the global Sustainable Development Goals. The urgency of doing so is heightened by emerging evidence of urban fertility stalls and reversals in some sub-Saharan African contexts as well as the significance of natural increase over migration in driving rapid urban growth. Moreover, there is new evidence from evaluations of large programmatic interventions focused on urban family planning that suggest ways to inform future programmes and policies that are adapted to local contexts. We present the key dimensions and challenges of urban growth in LMICs, offer a critical scoping review of recent research findings on urban family planning and fertility dynamics, and highlight priorities for future research

Urban Family Planning in Sub-Saharan Africa: an Illustration of the Cross-sectoral Challenges of Urban Health

The multi-sectoral nature of urban health is a particular challenge, which urban family planning in sub-Saharan Africa illustrates well. Rapid urbanisation, mainly due to natural population increase in cities rather than rural–urban migration, coincides with a large unmet urban need for contraception, especially in informal settlements. These two phenomena mean urban family planning merits more attention. To what extent are the family planning and urban development sectors working together on this? Policy document analysis and stakeholder interviews from both the family planning and urban development sectors, across eight sub-Saharan African countries, show how cross-sectoral barriers can stymie efforts but also identify some points of connection which can be built upon. Differing historical, political, and policy landscapes means that entry points to promote urban family planning have to be tailored to the context. Such entry points can include infant and child health, female education and employment, and urban poverty reduction. Successful cross-sectoral advocacy for urban family planning requires not just solid evidence, but also internal consensus and external advocacy: FP actors must consensually frame the issue per local preoccupations, and then communicate the resulting key messages in concerted and targeted fashion. More broadly, success also requires that the environment be made conducive to cross-sectoral action, for example through clear requirements in the planning processes’ guidelines, structures with focal persons across sectors, and accountability for stakeholders who must make cross-sectoral action a reality

Validation of the Arab Youth Mental Health scale as a screening tool for depression/anxiety in Lebanese children

<p>Abstract</p> <p>Background</p> <p>Early detection of common mental disorders, such as depression and anxiety, among children and adolescents requires the use of validated, culturally sensitive, and developmentally appropriate screening instruments. The Arab region has a high proportion of youth, yet Arabic-language screening instruments for mental disorders among this age group are virtually absent.</p> <p>Methods</p> <p>We carried out construct and clinical validation on the recently-developed Arab Youth Mental Health (AYMH) scale as a screening tool for depression/anxiety. The scale was administered with 10-14 year old children attending a social service center in Beirut, Lebanon (N = 153). The clinical assessment was conducted by a child and adolescent clinical psychiatrist employing the DSM IV criteria. We tested the scale's sensitivity, specificity, and internal consistency.</p> <p>Results</p> <p>Scale scores were generally significantly associated with how participants responded to standard questions on health, mental health, and happiness, indicating good construct validity. The results revealed that the scale exhibited good internal consistency (Cronbach's alpha = 0.86) and specificity (79%). However, it exhibited moderate sensitivity for girls (71%) and poor sensitivity for boys (50%).</p> <p>Conclusions</p> <p>The AYMH scale is useful as a screening tool for general mental health states and a valid screening instrument for common mental disorders among girls. It is not a valid instrument for detecting depression and anxiety among boys in an Arab culture.</p

Rural–Urban Migration and Experience of Childhood Abuse in the Young Thai Population

Evidence suggests that certain migrant populations are at increased risk of abusive behaviors. It is unclear whether this may also apply to Thai rural–urban migrants, who may experience higher levels of psychosocial adversities than the population at large. The study aims to examine the association between migration status and the history of childhood sexual, physical, and emotional abuse among young Thai people in an urban community. A population-based cross-sectional survey was conducted in Northern Bangkok on a representative sample of 1052 young residents, aged 16–25 years. Data were obtained concerning: 1) exposures—migration (defined as an occasion when a young person, born in a more rural area moves for the first time into Greater Bangkok) and age at migration. 2) outcomes—child abuse experiences were assessed with an anonymous self report adapted from the Conflict Tactics Scales (CTS). There were 8.4%. 16.6% and 56.0% reporting sexual, physical, and emotional abuse, respectively. Forty six percent of adolescents had migrated from rural areas to Bangkok, mostly independently at the age of 15 or after to seek work. Although there were trends towards higher prevalences of the three categories of abuse among early migrants, who moved to Bangkok before the age of 15, being early migrants was independently associated with experiences of physical abuse (OR 1.9 95%CI 1.1–3.2) and emotional abuse (OR 2.0, 95%CI 1.3–3.0) only. Our results suggest that rural–urban migration at an early age may place children at higher risk of physical and emotional abuse. This may have policy implications for the prevention of childhood abuse particularly among young people on the move

Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: the protocol for an epidemiological and genetic survey

Background: violence is a public health major concern, and it is associated with post-traumatic stress disorder and other psychiatric outcomes. Brazil is one of the most violent countries in the world, and has an extreme social inequality. Research on the association between violence and mental health may support public health policy and thus reduce the burden of disease attributable to violence. the main objectives of this project were: to study the association between violence and mental disorders in the Brazilian population; to estimate the prevalence rates of exposure to violence, post-traumatic stress disorder, common metal disorder, and alcohol hazardous use and dependence: and to identify contextual and individual factors, including genetic factors, associated with the outcomes.Methods/design: one phase cross-sectional survey carried out in São Paulo and Rio de Janeiro, Brazil. A multistage probability to size sampling scheme was performed in order to select the participants (3000 and 1500 respectively). the cities were stratified according to homicide rates, and in São Paulo the three most violent strata were oversampled. the measurements included exposure to traumatic events, psychiatric diagnoses (CIDI 2.1), contextual (homicide rates and social indicators), and individual factors, such as demographics, social capital, resilience, help seeking behaviours. the interviews were carried between June/2007 February/2008, by a team of lay interviewers. the statistical analyses will be weight-adjusted in order to take account of the design effects. Standardization will be used in order to compare the results between the two centres. Whole genome association analysis will be performed on the 1 million SNP (single nucleotide polymorphism) arrays, and additional association analysis will be performed on additional phenotypes. the Ethical Committee of the Federal University of São Paulo approved the study, and participants who matched diagnostic criteria have been offered a referral to outpatient clinics at the Federal University of São Paulo and Federal University of Rio de Janeiro