Flows of financial resources for health research and development in Brazil, 2000-2002

OBJECTIVE: To map and measure the flows of financial resources for health research and development in Brazil for the years 2000-2002. METHODS: After adapting the methodology developed for the Center for Economic Policy Research, data were collected on the sources and uses of resources for health research and development. RESULTS: The annual average value of resources apportioned to health research and development was approximately 573 million US dollars. The public sector as a whole invested 417.3 million US dollars and the health department 51.1 million US dollars. Expressed in percentages, the public sector invested 4.15% of the health department's budget although the Ministry of Health assigned only 0.3% of its budget to health research in the country. The universities and the research institutes are the main users of the resources allocated to health research and development, receiving 91.6% of the total public spending, while the private sector receives a small share of around 0.69% of the total. The private sector invested 135.6 million US dollars per year, and the international organizations 20.1 million US dollars per year. CONCLUSION: Besides measuring the financial resources made available for health research and development, the results allowed the filling of gaps in national information; the identification of the flows of applied financial resources; and the testing and adaptation of the proposed methodology, generating information suitable for international comparisons.     

The historical development of occupational health in Australia Part 2: 1970-2000

Australian occupational health was shaped by various social, political and economic forces during the latter half of the last century. An overall downturn in manufacturing and increased wage restraint during the early 1970s, encouraged trade unions to turn their attention to broader social issues, such as workplace health. Mainstream Australian society was also being influenced by wider community sentiment during this time, including anti-war protests, environmental lobby groups and the women's movement. Interest in occupational health subsequently flourished, with formalised education commencing in the 1970s, and the number of tertiary courses rapidly increasing throughout the 1980s. Occupational health and worker's compensation legislation similarly evolved throughout the latter stages of the twentieth century. Australian workplace health and safety is now based on a theory of self-regulation and managed in a tri-partite model, consisting of employers, trade unions and government departments. In Part 1 of our occupational health review, we outlined the historical development of Australian occupational health between 1788 and 1970. In the current paper, Part 2, we describe the historical development of Australian occupational health between 1970 and 2000.     

Causes of death in the Sami population of Sweden, 1961-2000

BACKGROUND: Indigenous people often have a pattern of mortality that is disadvantageous in comparison with the general population. The knowledge on causes of death among the Sami, the natives of northern Scandinavia, is limited. The aim of the present study was to compare gender and cause specific mortality patterns for reindeer herding Sami, non-herding Sami, and non-Sami between 1961 and 2000. METHODS: A Sami cohort was constructed departing from a group of index-Sami identified as either reindeer herding Sami or Sami eligible to vote for the Sami parliament. Relatives of index-Sami were identified in the National Kinship Register and added to the cohort. The cohort contained a total of 41 721 people (7482 reindeer herding Sami and 34 239 non-herding Sami). A demographically matched non-Sami reference population four times as large, was compiled in the same way. Relative mortality risks were analysed by calculating standardized mortality ratios (SMRs). RESULTS: The differences in overall mortality and life expectancy of the Sami, both reindeer herding and non-herding, compared with the reference population were relatively small. However, Sami men showed significantly lower SMR for cancers but higher for external causes of injury. For Sami women, significantly higher SMR was found for diseases of the circulatory system and diseases of the respiratory system. An increased risk of dying from subarachnoid haemorrhage was observed among both Sami men and women. CONCLUSIONS: The similarities in mortality patterns are probably a result of centuries of close interaction between the Sami and the non-Sami, while the observed differences might be due to lifestyle, psychosocial and/or genetic factors.     

Swiss cooperation in the development of public health in Tanzania]

Résumé De 1961 à 1978, l'Institut tropical suisse, avec l'apport financier de la Fondation bâloise pour l'aide à des pays en voie de développement et en collaboration étroite avec le «St. Francis Hospital», a monté et dirigé un centre de formation pour personnel africain médical, paramédical et auxiliaire, à Ifakara, en Tanzanie. Ce centre a été remis, sous forme d'un «Medical Assistants Training Centre», au Gouvernement de la Tanzanie qui assure sa continuité. 770 jeunes Africains y ont accompli, au cours de la période susmentionée, leur formation professionnelle et occupent aujourd'hui les postes correspondant à leur formation dans leur pays. La politique en matière de services de santé publique est exposée. Les résultats obtenus et les expériences faites sont discutés. Le bénéfice de l'entreprise apparaÎt comme étant marqué et mutuel. L'Institut tropical suisse envisage actuellement une continuation de la collaboration avec la Tanzanie, à partir de son laboratoire de terrain à Ifakara, surtout dans le domaine de recherches épidémiologiques appliquées, par exemple en vue de la lutte contre les schistosomiases.

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Swiss cooperation in the development of public health in Tanzania

Summary With the financial support of the Basle Foundation for Aid to Developing Countries and in close collaboration with the St. Francis Hospital, the Swiss Tropical Institute has set up and looked after a teaching centre at Ifakara, Tanzania, for the training of African medical, paramedical and auxiliary personnel. In the course of seventeen years, 770 young Africans have undergone training here. The centre has now been handed over in its final form as a Medical Assistants Training Centre to the Tanzanian Government, which has assumed full responsibility for its further direction and maintenance.The results obtained and the experience gained are discussed, as is the relationship of the centre to the public health policy of the Tanzanian Government. The writer considers that the whole undertaking has been of great mutual benefit and is looking forward to further collaboration between the Swiss Tropical Institute. Based on the Field Laboratory Ifakara, this will be mainly in applied epidemiological research, e.g. on schistosomiasis in and around Ifakara.

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Schweizerische Zusammenarbeit bei der Entwicklung des öffentlichen Gesundheitsdienstes in Tansania

Zusammenfassung Finanziell unterstützt von der Basler Stiftung zur Förderung von Entwicklungsländern und in enger Zusammenarbeit mit dem «St. Francis Hospital», baute und betrieb das Schweizerische Tropeninstitut in Ifakara, Tansania, eine Ausbildungsstätte für medizinisches und paramedizinisches Personal und medizinisches Hilfspersonal. Als «Medical Assistants Training Centre» wurde die Schule 1978 der Regierung Tansanias vertragsgemäss zur Weiterführung übergeben. In der Berichtsperiode erhielten 770 junge Afrikaner, ganz oder teilweise, ihre fachliche Ausbildung in Ifakara. Sie stehen heute mit Erfolg im Einsatz ihres Landes. Die Landespolitik bezüglich des öffentlichen Gesundheitsdienstes und die Rolle, welche in diesem Rahmen den «Medical Assistants» zukommt, werden dargelegt. Die erzielten Ergebnisse und die gemachten Erfahrungen werden erörtert. Das Unternehmen erwies sich als für beide Seiten von grossem Nutzen. Das Schweizerische Tropeninstitut schickt sich an, mit Tansania auf dem Gebiet der angewandten epidemiologischen Forschung weiter zusammenzuarbeiten, indem es gegenwärtig vorerst eine Felderhebung über Schistosomiase in und um Ifakara in Angriff nimmt.

     

Present health situation in Tanzania

This article discusses the present health situation in Tanzania, however, health system before independence, the colonial health system, has been the foundation on which the present health services in Tanzania are built upon. The population growth in Tanzania is high (3.2% in 1986), and projected to be 3.7% by the year 2,000. This high growth explains why it is difficult to achieve health objectives on the long term basis. Compounded to this is the economical crisis in the country. Child population in Tanzania account for about 47% of the total population in 1986. Maternal and Child Health Care services (MCHC) are discussed, with much emphasis on the child health care problems, and different programmes involved in improving child health care in the country. Problems of poor environmental sanitation are discussed including possible solutions for Tanzania. Tanzania, in this article, is urged to strengthen the existing health services in terms of staff, drugs, other supplies and equipment in order to give adequate health care to its people. Tanzania should also balance the distribution of resources between urban and rural so as to comply with the objective of the national health policy of comprehensive basic health services equitably to all within the limited available resources and to be able to reach the ultimate goal of health for all the people in the country by the year 2,000.     

The long-term health and economic consequences of the 1959-1961 famine in China

This paper, using a difference-in-differences method, tries to quantify the long-term effects of China's 1959-1961 famine on the health and economic status of the survivors. We find that the great famine caused serious health and economic consequences for the survivors, especially for those in early childhood during the famine. Our estimates show that on average, in the absence of the famine, individuals of the 1959 birth cohort would have otherwise grown 3.03 cm taller in adulthood. The famine also greatly impacted the labor supply and earnings of the survivors with famine exposure during their early childhood.     

Knowledge and health information communication in Tanzania

OBJECTIVE: To explore and identify gaps in knowledge and information communication at all levels of health delivery system in Tanzania. METHODS: In-depth interviews and twelve Focus Group Discussions were conducted to capture information on the community knowledge on different health problems and the health information communication process. Interviews and discussions were also held with primary schoolchildren, traditional healers, health facility workers and district health management team members. Documentary review and inventory of the available health education materials at community, health facility and district levels, was made. RESULTS: Major community health and health-related problems included diseases (61.6%), lack of potable water (36.5%), frequent famine (26.9%) and lack of health facility services (253%). Malaria, HIV/AIDS and diarrhoeal diseases were the leading causes of morbidity and mortality. Most of the health communication packages covered communicable diseases and their prevention. Health care facility was the main (91.6%) source of health information for most communities. Public meetings, radio and print materials were the most frequently used channels of health information communication. Major constraints in adopting health education messages included poverty, inappropriate health education, ignorance and local beliefs. CONCLUSION: This study has identified gaps in health knowledge and information communication in Tanzania. There is lack of adequate knowledge and information exchange capacities among the health providers and the ability to share that information with the targeted community. Moreover, although the information gets to the community, most of them are not able to utilize it properly because they lack the necessary background knowledge.     

On medicine and health enhancement - Towards a conceptual framework

This paper contains an attempt at constructing a semantic framework for the field of health enhancement. The latter is here conceived as an extremely general category covering the whole area of health care and health promotion. With this framework as a basis I attempt to define the place of medicine within the enterprise of health enhancement. I finally indicate some normative issues for the future, in particular problems and possible developments for medicine as a species of health enhancement.This revised version was published online in October 2005 with corrections to the Cover Date.     

The political economy of health care: colonial Namibia 1915-1961

The political economy of health care services in colonial Namibia during 1915-1961 closely reflected the extreme racial and class imbalance of power in a conquest state. The colonial power allocated to the indigent nine-tenths, the poorest nine-tenths of the people, an average 43% of the health care budget between 1922 and 1954. The League of Nations mandate proved toothless in pressuring the Mandatory power to rectify this or other inequalities.     

Sociocultural barriers and malaria health care in Tanzania

In Tanzania, since the time of its ancestors, cultural beliefs have existed which influence the treatment and management of diseases. This article focuses on malaria as a current major cause of morbidity and mortality in Tanzania. Patients and caretakers have tended to rely on traditional sociocultural practices as a means of treating the convulsions associated with severe malaria in children and often do not seek care at health facilities, therefore, delaying prompt management of the disease.