Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017160 (gastroenteritis)
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Geographical areas in the Cape Province are ranked by their need for resources for child health care as determined by several proxy indicators of child health. Low birthweight and perinatal mortality rates for 1989, infant and age-specific childhood death rates, as well as death rates for tuberculosis, gastroenteritis and measles for 1985 are used as indicators of need. The ten magisterial districts having the highest priority for resources are, in decreasing order of need: De Aar, Colesberg, Uitenhage, Sterkstroom, Gordonia, Prince Albert, Philipstown, Victoria West, Kirkwood and Richmond. Limitations in the data are: wide, unquantifiable confidence limits, non-independence of different indicators, lack of timeliness, and incomplete statistics. Despite these problems with the data there are several reasons for employing them. Firstly, the quality of the data is only likely to be improved if they are actually used, and, secondly, there is no alternative. Areas identified as high priority need investigation in situ because corrective action is required for either the data collection system, or child health. Recommendations for improvements in resource management in child health care are: regionalisation of a unitary health care service, more timely data collection in geographically standardised regions, introduction of management objectives, and resource allocation guided by health status indicators.
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PMID:Priorities for provision of health care services for children in the Cape Province. 194 62

Lessons learned from Haiti's integration of a training program for traditional birth attendants with the maternal and child health and family planning program are reported. The available data on illness and deaths reveal that Haiti has continuing problems of gastroenteritis, malnutrition, tuberculosis, malaria, and tetanus. The latter is of particular interest since neonatal tetanus derived from umbilical cord contamination continues to affect up to 10-20% of Haitian newborns in rural areas lacking health programs. Neonatal tetanus has largely disappeared in the Artibonite Valley due to a mass immunization program for the entire population, including young women, against tetanus. In the Albert Schweitzer Hospital program for indigenous midwives in Artibonite Valley, at least 36 midwives were reached on a regular basis in 1968 -- less than 1/3 of the midwives operating in the Artibonite Valley. There was a rapid decline in neonatal tetanus admissions during the period following 1968. This decline has been attributed to the use of rural health auxiliaries in immunizing the women in the hospital district, but indigenous midwives may have played a role. By 1970, the Albert Schweitzer Hospital program had grown from 36 midwives regularly attending midwife classes to 175 registered with the program during 1970. Although direct supervision proved difficult due to lack of communication and transport to the scene of delivery, some deliveries were observed and indirect supervision by the community became evident. An important finding of the traditional midwife training program of the Albert Schweitzer Hospital was the amount of time required for an indigenous midwife to have referred 50 newborns to the hospital for BCG vaccination. At the end of the 1st year of this program, only 2 midwives reached this goal. Another surprise was the increase in demand for "cord cut" services at the outpatient clinic rather than increased use of the nearby maternity unit. The elimination of neonatal tetanus as a cause of infant mortality was the most important outcome of the maternal and child health component of the community health program.
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PMID:Traditional midwives, tetanus immunization, and infant mortality in rural Haiti. 667 3