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The challenge of achieving health for all is enormous in the face of 500,000 maternal deaths a year; the fact that 2.9 billion people lack clean water and sanitation; the AIDS epidemic and malaria prevalence; substance abuse; population aging; runaway urbanization; environmental degradation; and violent human conflicts. To develop new ways of thinking and approaches, programs initiated by the Health Foundation of the Rogosin institute of New York entitled Problem-Solving for Better Health. The basic concept was that available limited resources (preventive, therapeutic, information, talent, and community) are seldom fully utilized, rather than are often wasted. The program involves attendance of a workshop lasting 3-5 days by 60 health professionals. The problem-solving strategies are discussed in large groups with a handbook for supporting presentations. Community involvement and international collaboration are stressed, and follow-up site visits take place after 6 months. The Health Foundation's INFO-MED computer program and interactive information centers provide up-to-date information for professionals working on health problems. In China, 54 professionals collaborated to solve health problems. In 1992, progress reports for 21 projects dealt with anxiety, violent behavior, attention-deficit disorders, hyperlipidemia, and wound healing. In Brazil, 53 health professionals were enrolled in 1990 and prepared some 50 solutions to problems, including patterns of violence among young males in Sao Paulo and nutritional deficiencies in slums. Six projects were implemented with 36 under development. In Ghana, 65 professionals devised solutions to problems in 1991, 12 projects are under way, and 1 on hearing problems in school children is ready for national implementation. In the US, a team from the University of Illinois Medical School launched a program in 1992 on geriatric, pediatric, and women's health issues. In Guyana, 70 professionals participated in a workshop in 1992 to strengthen community-based programs. In Nigeria, also in 1992, 78 participants prepared protocols on family planning, guinea-worm eradication, and environmental health.
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PMID:Problem-solving for better health. 814 91

The United Nations Children's Fund has labeled street children as children in difficult circumstances, which represent a minority population that has been under-represented for too long in health research. This is a concern because street children are at risk of carrying a greater disease burden. Their homeless lifestyle makes them more vulnerable to health risks and problems than children who live at home; as they roam the streets begging for food and money to obtain basic needs and are found sleeping in half-destroyed houses, abandoned basements, under bridges and in the open air. This paper presents health results from a systematic review of literature from 17 databases and including 16 countries in Africa. The review revealed that there are more boys than girls living on the street in their adolescence and who mainly have left home due to poverty and abuse. These children in these countries are vulnerable to poor health due to factors such as homelessness, risky sexual behavior, substance abuse and violence. Among the health problems identified are growth and nutritional disorders, physical injuries, violence, sexual abuse, communicable diseases including diarrheal diseases, malaria, respiratory diseases, neglected tropical diseases, mental health issues, substance abuse, reproductive health disorders, mortality, sexually transmitted diseases and HIV/AIDS. Primary interventions that could prevent poor health and improve the health status of street children include provision of safe shelter, proper nutrition, access to health care, health education, and sexual reproductive health, protection from any form of abuse, violence and substance abuse. Enforcing state policies and laws in all African countries is required to protect street children from neglect, abuse and to increase their access to education. More research on the health risks and health status of street children is still required, particularly in Sub-Saharan Africa, which carries the greatest disease burden and poverty.
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PMID:The Health Profile of Street Children in Africa: A Literature Review. 2829 48

Pregnant women experience unique physiological changes pertinent to the effective prevention and treatment of common diseases that affect their health and the health of their developing fetuses. In this paper, the impact of major communicable (HIV/AIDS, tuberculosis, malaria, helminth infections, emerging epidemic viral infections) as well as non-communicable conditions (mental illness, substance abuse, gestational diabetes, eclampsia) on pregnancy is discussed. The current state of research involving pregnant women in these areas is also described, highlighting important knowledge gaps for the management of key illnesses that impact pregnancy globally.
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PMID:Pregnancy and the global disease burden. 2929 7