Food-poverty status and food insecurity in rural West Lombok based on mothers' food expenditure equivalency.

Background: When the Central Bureau for Statistics (CBS) developed a national food-poverty line for Indonesia, some aspects, such as food availability,food beliefs, and food habits, were not considered. In addition, the reference population was determined on the basis of their nonfood expenditures.

Objective: To develop and use a method applicable in any given sociocultural setting, as well as to determine food-poverty status in rural West Lombok, Indonesia, using mothers'food expenditure equivalency (FEE).

The effectiveness of patient referral in Pakistan.

In Pakistan, despite an elaborate network of over 5000 basic health units and rural health centres, supported by higher-level facilities, primary health care activities have not brought about expected improvements in health status, especially of rural population groups. A poorly functioning referral system may be partly to blame. System analysis of patient referral was conducted in a district of Punjab province (Attock) for the purpose of identifying major shortcomings, if any, in this domain.

Monitoring of primary health care services: an example from western Uganda.

Results from baseline and follow-up surveys of the Basic Health Services Program in Kabarole District, Western Uganda carried out in 1989 and 1991 are presented. Indicators in relation to management capability, infrastructure, levels of basic knowledge and skills of health staff, community involvement and utilization of health services were measured. Subjectivity of the data collection was minimized through use of a randomized study design, and external supervision.

Who is the child at risk?

Prior to the establishment of a nutrition intervention programme in the Bagamoyo district of rural Tanzania, all children residing in eleven randomly selected villages were weighted and a number of social and community variables collected. The survey served the dual purpose of providing a baseline to subsequently measure programme impact and identifying the child at risk of becoming malnourished. Despite the survey being carried out during a season of relative scarcity of food, results suggest a relatively benign level of malnutrition in relation to other regions of Subsaharan Africa or other developing countries.

The burden of disease among preschool children from rural Tanzania.

A study was undertaken to determine disease prevalence of, choice of treatment for, as well as health services utilization by, preschool children living in a rural district of coastal Tanzania. Disease prevalence and choice of treatment were determined through seven-day recall; health services utilization through systematic analysis of Village Health Workers' service records over one calendar year. It was found that the main disease symptoms, i.

Cost and effectiveness of different approaches to schistosomiasis control in Africa.

In order to analyze the cost-effectiveness of selected mass-chemotherapy, a model is used to compare the treatment of urinary schistosomiasis with metrifonate (3 dose regimen, fortnightly intervals) and praziquantel (one dose regimen). The model was applied to two situations. Setting I, based on experiences in the Peoples Republic of the Congo, assumes that the average distance between the project base and the area of intervention is 80 km, the other, setting II, based on the situation in Mali, assumes an average distance of 250 km.

Control of deaths from diarrheal disease in rural communities: II. Motivating and monitoring the community.

In 1980 the Ministry of Health of Egypt undertook a short term investigation into means and methods to reduce the annually excessive number of preschool child deaths from Diarrheal Disease. This investigation sought to identify ways to overcome constraints related to logistics, supplies, and community participation. The unifying theme of this study was to examine the feasibility of stressing Oral Rehydration Therapy (ORT) instead of the then conventional parenteral treatment and heavy use of antibiotics.

Control of deaths from diarrheal disease in rural communities. I. Design of an intervention study and effects on child mortality.

From May through October 1980, the "Strengthening Rural Health Delivery" project (SRHD) under the Rural Health Department of the Ministry of Health of Egypt had conducted an investigation into prevention of child mortality from diarrheal disease through testing various modules of Oral Rehydration Therapy delivery mechanisms. In a six-cell design counting a total of almost 29,000 children, ORT was provided both as hypotonic sucrose/salt solution prepared and administered by mothers and normotonic, balanced electrolyte solution in the hands of both mothers and health care providers and the effects on child mortality during the peak season of diarrheal incidence were measured. In addition, utilization and effects of ORT when made readily available through commercial channels was similarly examined.

Evaluating tetanus neonatorum as a child survival risk in rural Egypt in the absence of reliable cause-of-death registration.

The principal finding of the investigation is that neonatal tenanus is, indeed an important cause of infant death in rural Egypt even though the normal cause-of-death reporting system had not altered health authorities to the problem. The finding is based on a comparison of registration statistics with (anthropological) reconstruction of pregnancies and child survival using the case-history rather than the epidemiological method. The histories go back ten years and refer to 102 women in two villages of Egypt.

Nutrition intervention: an evaluation of six studies.

Six nutrition intervention studies were evaluated in the context of a predetermined methodology covering several categories of evaluative criteria. After a presentation of reasons for including each study, a summary is presented of the results of each study in light of the present investigators' evaluation and secondary analyses. Nutrition intervention programs can have a positive effect on health indices of infants and children, but much can be done in future nutrition projects to improve project design and thereby assist and facilitate more meaningful evaluations of nutrition intervention.

Complement (C3), nutrition, and infection.

Complement (C(3)) was determined and related to various parameters of nutritional status and past infectious disease experience in a group of 53 rural preschool children in North India. Mean complement level was 25% lower than in an age-matched European reference population. Low complement (C(3)) levels were associated mainly with children who were both stunted and wasted, as well as with those who had experienced frequent purulent skin infections in the past.

The Narangwal Nutrition Study: a summary review.

Between April 1968 and May 1973 the department of International Health of The Johns Hopkins University carried out investigations into the interactions of malnutrition and infection and their effects on preschool child growth, morbidity and mortality in 10 villages of Punjab, North India. Base line surveys before the introduction of services revealed a high prevalence of malnutrition and undernutrition and infectious disease morbidity, as well as lack of accessibility, underutilization and poor population coverage of governmental health services. Study villages were selected in separate clusters and allocated to a control group and three service groups in which nutrition care and medical care were provided singly and in combination by auxiliary health workers resident in each village.

Weight-for-age as an index of risk of death in children.

Between April, 1968, and May, 1973, the Department of International Health of Johns Hopkins University studied the effects of the interaction of nutrition and infection in fourteen villages of Punjab, North India. Serial anthropometric measurements (used as index of nutritional status) and vital statistics of almost 3000 children aged 1-36 months showed that, on average, child mortality doubled with each 10% decline below 80% of the Harvard weight median. The relation between season and mortality showed that mortality-rates were highest just before and during the main (wheat) harvest, reflecting the effects of food scarcity, relative child neglect, and climate on child deaths among those already underweight.

Weight fluctuations after immunization in a rural preschool child community.

After inoculations with diphtheria, pertussis, tetanus (DPT), smallpox Bacillus Calmette-Guèrin (BCG), polio, and DPT + polio vaccine preparations, weight-for-age fluctuations were monitored in over 470 rural preschool children and compared to those in nonvaccinated control children matched for age, weight-for-age, season and year of immunization, and village affiliation. It was found that children immunized with live agents (BCG, smallpox, polio, DPT + polio) who also were below 6 months of age suffered statistically significant reductions in their weight-for-age compared to matched nonimmunized controls. Children inoculated with polio or smallpox who also were below 80% of the Harvard weight-for-age median experienced a larger decrease in their nutritional levels than those above, with correction for age distribution.

The effect of nutritional status on immune capacity and immune responses in preschool children in a rural community in India.

Cell-mediated immune response (CMI) and several aspects of humoral immune status and response were measured and related to nutritional status in preschool children in north India. CMI was measured by means of postvaccinal (BCG) tuberculin sensitivity and leucocytic blast cell transformation. Humoral immune response was measured by means of tetanus antibody production following vaccination with diphtheria-pertussis-tetanus vaccine.

Etiological determinants of protein calorie undernutrition in a rural child community.

Two groups of randomly selected underweight and well-nourished preschool children residing in study villages of Punjab, Ludhiana district were examined with respect to their socioeconomic background, birth weights, dietary intakes, quality of received mother care, blood biochemistry, parasite load, psychomotor development and past illness prevalence. It was found that underweight children showed significantly less favourable indices in all of the above categories except stool parasitology suggesting an extremely intricate and complex interaction of a host of ecological variables in the causation of undernutrition. Using the discriminate analysis on readily available social variables, it was found that caste affiliation and, less so parental income were the two most significant variables distinguishing between the two groups.