The problems and perspectives of schoolchildren's health promotion at the municipal level

The paper gives the results of studies aimed at evaluating the efficiency of the interdepartmental interaction system in schoolchildren's health promotion at the municipal level and at substantiating the recommendations for its optimization in case of the Leninsky District (Yekaterinburg). A package of measures, such as to develop the network of health-promotion schools, to assist in introducing effective health-saving technologies, to upgrade the personnel's competence in health culture, and to develop monitoring systems is proposed.     

Intersectoral problems in the Russian organisation of public health

In spite of the ongoing transition of the Russian society, there is still a traditional view of public health, which is based to a great extent on the ideals and priorities of the Soviet period. Public health activities are regarded mainly as a responsibility of the health sector. There are, however, important public health activities going on also in other sectors of the society, for example, in the educational sector and the local communities, but also in the social insurance system. There is an important Russian tradition of prophylactic treatment in sanatoriums and health resorts, which is financed to a large extent by the social insurance. Based on three qualitative empirical studies, this article describes the organisation of public health in the Russian Federation and analyses the problems of intersectoral co-ordination and collaboration within this organisation. The analysis is focusing on the relations between the health sector and the social insurance system, which are not so well known outside the country. The results of this analysis show a fragmented organisation with a serious lack of co-ordination, but also a limited collaboration between the different sectors involved in public health. On the basis of these results, there is a discussion of how intersectoral collaboration could be improved in the Russian organisation of public health.     

Collecting health information at a local level

Target 35 of the ‘Health for All’ strategy statesthat "member states should have health information systems capableof supporting their national strategies for Health for All". in Rorterdam a local health information system has been developedwhich aims to:

• Monitor the health situation and related factors in the cityof Rotterdam at district and neighbourhood level;
• Contributeto the development of a local health policy for reducingthenoted differences in the health situation of the population.

information is collected from various sources including:

• data on mortality and morbidity and statistics concerning healthrelated areas like housing, employment, traffic, environment,etc.;
• data collected from the population itself;
• ideas andviews of key informants;
• documentary information.

The article outlines the design of the system, gives a reviewof the information stored and presents some of the results.     

Occupational health in Cuba.

Health and safety regulation, training, and research were practically non-existent in Cuba before the Revolution in 1959. Since that time important advances have been made. Specialized inspectors, occupational physicians, and other such personnel are now trained in Cuba. An Occupational Health Institute, founded in 1976, provides training and specialized technical services, and conducts research. In 1978, a far reaching "Work Safety and Health Law" was enacted which defines the rights and responsibility of government agencies, workplace administrators, unions, and workers. Comprehensive control of toxic substances in workplaces, still at an early stage, is likely to increase in light of the new law, the growing availability of qualified personnel, and the mounting concern of public health authorities with the increasingly "developed" health profile of the population.     

An action plan for tobacco control at regional level

Smoking is the single biggest preventable cause of death in the UK; killing over 120 000 people each year, contributing to inequalities in health, exacerbating and causing poverty. Smoking has increased steadily among children since 1988 and more recently, among young adults. The current context in the UK is highly favourable for introducing comprehensive tobacco control measures. This paper summarises a regional action plan for tobacco control. Actions at district and regional levels are outlined to establish a comprehensive local tobacco control framework and complement national tobacco control measures. Measures include: a 'SWOT' analysis of current activity; systematic monitoring of smoking prevalence, attitudes to smoking, and the impact of tobacco control interventions; provision of effective smoking cessation support to a minimum standard throughout the health service; increased coverage of smoke-free public places and workplaces; enforcement of legislation on illegal sales to children and against smuggling and selling illegally imported tobacco; paid and unpaid mass media campaigns; and systematic lobbying for fiscal and legislative measures. One of the key components of the plan is the introduction of evidence-based tobacco control strategies at district levels. These should include a performance framework with clear organisational and managerial accountability and employ a co-ordinated, multiagency, partnership approach. Priority groups should be identified. Strategies should seek to engage the public to build support for tobacco control measures. Sufficient time, staff, resources and training must be allocated to tobacco control work and progress towards objectives monitored.     

Evaluation of health surveillance at several primary care units in Cuba]

BACKGROUND: The organization and operation of the epidemiological monitoring carried out at several Primary Care facilities in Cuba was assessed by means of a study conducted for the purpose of ascertaining the effectiveness of the monitoring in question and of contributing to further improve the mechanisms thereof and thus improve the health conditions of the population. This assessment was implemented at eight Polyclinics in the city of Havana throughout the 1998-1999 period. METHOD: By means of the implementation of an integral methodology, an assessment was made of the three factors involved in the monitoring system at the facilities in question, that is, the organization, the process and the results thereof. For this purpose, a survey which quantified some aspects of the system (sensitivity, opportunity, representativeness, usefulness) and a semi-structured survey of epidemiologists and other physicians involved in the monitoring in question in addition to the users of the system was used. RESULTS: The assessment of the organization revealed the monitoring organization to be adequate. In the assessment of the process, sensitivity was found to be low at some polyclinics, problems existing at many of them with regard to the opportunity and flexibility of the system. The assessment of the results of the monitoring revealed them to be satisfactory as regards their effectiveness for detecting acute events, as well as in the perception of the users with regard to the usefulness of these results for solving the problems pinpointed. CONCLUSIONS: The monitoring done at the polyclinics assessed is indicative of there being an adequate organization of the monitoring, although some shortcomings were found to exist with regard to the fulfillment of some aspects of the monitoring. This however has no bearing on the results for the system as a whole, which is capable of detecting any epidemiological situation of importance and of suggesting appropriate measures for controlling the situation.     

省市级疾控中心卫生信息化人才队伍现况调查

目的了解中国大陆地区省市级疾病预防控制中心(CDC)公共卫生信息化人才队伍现状。方法利用流行病学动态数据采集平台(EDDC)实现调查问卷的定制和在线发布,通过在线自填方式对全国省市级CDC 1 281名公共卫生信息化人员进行问卷调查。结果2.7%(34/1 281)的CDC公共卫生信息化人员既有IT专业背景又有医学背景;接受过单位安排培训的占74.7%(957/1 281);在对单位安排的卫生信息化培训次数满意度方面,东部地区优于中部地区(t=2.89,P=0.0119);最调动员工工作积极性的激励因素中\