Water supply status of a community and its attitude towards using a new method for raw water treatment

Abstract: A pre-intervention sample survey was carried out on a study community in North Omo Zone (Southwest Ethiopia) with regard to its water supply status. This survey was done before introducing a new technique of using the seeds of Moringa stenopetala in raw water treatment at the household level. A total of 100 out of 550 houses in Qola Shara, the study community , were surveyed using a questionnaire. The study reveals that the community is totally exposed to the risk of water related diseases. It also evaluates the attitude of the community members towards the use of Moringa seeds for the treatment of drinking water. It was observed that all members of the study group would like to try and see the effect of the seeds in water treatment. [Ethiop. J. Health Dev. 1996;10(2):83-87

Equity Aspects of Canadian Immunization Programs: Differences within and between countries

There is a global recognition that immunization is one of the most cost-effective public health interventions which should be available to everyone.  The equity approach to immunization provides a holistic and integrated framework for addressing inequalities and disproportions in the realization of human rights. The aim of this study is to review the performance of the immunization programs in Canada through an equity lens using two analytical frameworks for immunization programs. It focuses on four elements of the programs: a) the burden of disease; b) immunization strategy; c) ability to evaluate; and d) research questions.  To achieve universal access to vaccination, Canada should have a strong connection with human rights, where realities and outreach need to be prioritized. Preventable diseases such as influenza, H1N1, and varicella have been reported specifically in Aboriginal Canadians, immigrants and refugees. Our study seeks to demonstrate that access to vaccines should be considered one of the most vital human rights and as a matter of fundamental intervention to achieve health equity

Community awareness and practice of family planning in an urban community in Addis Ababa, Ethiopia

Abstract: To assess community awareness and practices concerning family planning in an urban community in Addis Ababa, Ethiopia, a survey was carried out in June and July 1993. Of the 536 people interviewed 332 (61.9%) had heard about family planning. The contraceptive prevalence rate in the community was 29.5%, with oral contraceptive pills being the most popular method. Contraceptive methods usage rate was observed to be significantly higher among people with permanent job (OR=1.98), among highly educated (OR=3.82) and among people with larger family size (OR=1.92) compared to the others. Health workers and radio were the main sources of family planning information, by 70% and 20% of the study population, respectively. The major barriers to contraceptive use were fear of side-effects and religious taboos. Only 4% of the study population obtained their contraceptives from hospitals and private clinics, and over 90% of the respondents suggested that contraceptives be distributed free of charge. The study demonstrated that there still exists a wide gap between the knowledge about contraception and actual use. Expansion of family planning services through inexpensive and more accessible means and strengthening of individual counselling are recommended as ways to reduce this gap. [Ethiop. J. Health Dev. 1995;9(3):133-139

The Attitudes of students, parents and teachers towards the promotion and provision of condoms for adolescents in Addis Ababa

Abstract: A cross-sectional descriptive survey through a self-administered, anonymous and structured questionnaire was conductd from September to December, 1993, in ten high schools in Addis Ababa to determine the sexual behaviour of adolescents, their knowledge about AIDS, attitudes and practices regarding condoms, their attitudes towards the promotion and distribution of condoms in schools, and towards the incorporation of health and sex education into the regular teaching curricula and into the teachers’ training curricula. A total of 910 parents, 755 students and 232 teachers participated in the survey. The results showed that, of the 755 students, 39.8% of the boys and 5.6% of the girls have had sexual experience. Peer pressure (35.2%) and force (21.6%) were the most important factors that precipitated the first sexual encounter. Ten percent of the students had coital contact with a commercial sex worker. Only 42.2% of the sexually active students used condoms on their first sexual encounter, and only 27.7% used condoms continuously on their subsequent sexual encounters. An overwhelming majority in each of the three categories, (92.6% of the students, 98.7% of the parents and 96.1% of the teachers), approved the incorporation of health education into the regular teaching curricula. The idea of sex education in schools was also approved by 80.1% of the students, 90.9% of the parents and 96.1% of the teachers. This study, based upon the findings, recommends that education and health policy makers make relentless effort to commence health and sex education by incorporating them into the regular curricula; the implementation of subsequent surveys to identify the most effective and acceptable routes of condom distribution in school; and implementation of similar surveys in the rural settings to assess the attitudes in a different setting and acquire a more general overview for the whole country. [Ethiop. J. Health Dev. 1997;11(1):7-16

No. 2: The Brain Drain of Health Professionals from Sub-Saharan Africa to Canada

Significant numbers of African-trained health workers migrate every year to developed countries including Canada. They leave severely crippled health systems in a region where life expectancy is only 50 years of age, 16 per cent of children die before their fifth birthday and the HIV/AIDS crisis continues to burgeon. The population of Sub-Saharan Africa (SSA) totals over 660 million, with a ratio of fewer than 13 physicians per 100,000. SSA has seen a resurgence of various diseases that were thought to be receding, while public health systems remain inadequately staffed. According to one report, the region needs approximately 700,000 physicians to meet the Millennium Development Goals. Understaffing results in stress and increased workloads. Many of the remaining health professionals are ill-motivated, not only because of their workload, but also because they are poorly paid, poorly equipped and have limited career opportunities. These, in turn, lead to a downward spiral where workers migrate, crippling the system, placing greater strain on the remaining workers who themselves seek to migrate out of the poor working conditions. The ultimate result is an incontestable crisis in health human resources throughout SSA, the region suffering most from the brain drain of health care professionals. The situation in SSA has become severe enough that the final report of the Joint Learning Initiative on Human Resources for Health – a two-year global initiative sponsored by a number of donors studying various aspects of human resources for health performance – has concluded that the future of global health and development in the 21st century lies in the management of the crisis in human resources for health. There is a considerable body of literature attesting to the fact that the migration of skilled professionals from developing to developed countries is large and increasing dramatically. While different experts espouse different reasons for the increase, all agree that it is happening. Developing countries are hit hardest by the brain drain as they lose sometimes staggering portions of their college-educated workers to wealthy countries which can better weather their relatively smaller losses of skilled workers. Highly skilled professionals account for 65 per cent of migrants moving to industrialized countries. The International Organization for Migration (IOM) estimates that about 20,000 Africans leave Africa every year to take up employment in industrialized countries. We do not know how many of these are health care professionals (largely because of inadequate systems for gathering such statistics in African countries).11 The World Health Organization (WHO), however, found that a quarter to two-thirds of health workers interviewed in a recent study expressed an intention to migrate. Historically, and specific to the SSA context, the brain drain has meant not only the exodus of human capital but financial resources as well, as African health care professionals left countries with their savings and reinvested very little of their foreign earnings back into the region. There is only recent evidence suggesting that, while the numbers of professionals leaving continue to increase, émigrés are slowly reinvesting some of their earnings back into their countries. Other research raises doubts about the value of such reinvestments, however, particularly when they are in the form of remittances that are generally private welfare transfers back to family members and are often used for consumption rather than for savings. In recognition of the enormous challenge posed by the international migration of health personnel to health systems in developing countries, the World Health Organization has proclaimed 2005-2015 the decade on human resources for health (HRH)

Traditional Music as a Sustainable Social Technology for Community Health Promotion in Africa: “Singing and Dancing for Health” in Rura Northern Ghana

Music is a social technology of enormous potential for improving communityhealth. This paper reports on a series of applied ethnomusicological interventions, enacted as a participatory action research project in northern Ghana, for health promotion. Initial interventions, performed by local professional urban artists, proved effective. But as they were not sustainable, we followed up by training village-based amateur youth groups, rooted in the local community, to perform a similar repertoire. These methods can be transposed to other societies maintaining participatory musical traditions, leading to improved community health whenever behavior is a primary determinant, as is so often the case (WHO 2002)

No. 2: The Brain Drain of Health Professionals from Sub-Saharan Africa to Canada

Significant numbers of African-trained health workers migrate every year to developed countries including Canada. They leave severely crippled health systems in a region where life expectancy is only 50 years of age, 16 per cent of children die before their fifth birthday and the HIV/AIDS crisis continues to burgeon. The population of Sub-Saharan Africa (SSA) totals over 660 million, with a ratio of fewer than 13 physicians per 100,000. SSA has seen a resurgence of various diseases that were thought to be receding, while public health systems remain inadequately staffed. According to one report, the region needs approximately 700,000 physicians to meet the Millennium Development Goals. Understaffing results in stress and increased workloads. Many of the remaining health professionals are ill-motivated, not only because of their workload, but also because they are poorly paid, poorly equipped and have limited career opportunities. These, in turn, lead to a downward spiral where workers migrate, crippling the system, placing greater strain on the remaining workers who themselves seek to migrate out of the poor working conditions. The ultimate result is an incontestable crisis in health human resources throughout SSA, the region suffering most from the brain drain of health care professionals. The situation in SSA has become severe enough that the final report of the Joint Learning Initiative on Human Resources for Health – a two-year global initiative sponsored by a number of donors studying various aspects of human resources for health performance – has concluded that the future of global health and development in the 21st century lies in the management of the crisis in human resources for health. There is a considerable body of literature attesting to the fact that the migration of skilled professionals from developing to developed countries is large and increasing dramatically. While different experts espouse different reasons for the increase, all agree that it is happening. Developing countries are hit hardest by the brain drain as they lose sometimes staggering portions of their college-educated workers to wealthy countries which can better weather their relatively smaller losses of skilled workers. Highly skilled professionals account for 65 per cent of migrants moving to industrialized countries. The International Organization for Migration (IOM) estimates that about 20,000 Africans leave Africa every year to take up employment in industrialized countries. We do not know how many of these are health care professionals (largely because of inadequate systems for gathering such statistics in African countries).11 The World Health Organization (WHO), however, found that a quarter to two-thirds of health workers interviewed in a recent study expressed an intention to migrate. Historically, and specific to the SSA context, the brain drain has meant not only the exodus of human capital but financial resources as well, as African health care professionals left countries with their savings and reinvested very little of their foreign earnings back into the region. There is only recent evidence suggesting that, while the numbers of professionals leaving continue to increase, émigrés are slowly reinvesting some of their earnings back into their countries. Other research raises doubts about the value of such reinvestments, however, particularly when they are in the form of remittances that are generally private welfare transfers back to family members and are often used for consumption rather than for savings. In recognition of the enormous challenge posed by the international migration of health personnel to health systems in developing countries, the World Health Organization has proclaimed 2005-2015 the decade on human resources for health (HRH)

Strategic Responses to Fiscal Constraints: A Health Policy Analysis of Hospital-Based Ambulatory Physical Therapy Services in the Greater Toronto Area (GTA)

Purpose: Ambulatory physical therapy (PT) services in Canada are required to be insured under the Canada Health Act, but only if delivered within hospitals. The present study analyzed strategic responses used by hospitals in the Greater Toronto Area (GTA) to deliver PT services in an environment of fiscal constraint