RESUMO
PIP: Ana Irsa (Nisoris) Aquina, 39, a mother of seven, grandmother, wife, and voluntary community health facilitator, lives in the Dominican Republic. Nisoris counsels women and their partners about reproductive health, provides child survival information to new mothers, and dispenses common remedies for diarrhea and respiratory infections as well as contraceptives (mainly oral contraceptives and condoms). These supplies are financed by Fundacion para el Desarrollo Communitario (FUDECO), a nongovernmental agency which is a member of the Save the Children alliance. FUDECO's work includes the development of water systems, health services, schools, and soil conservation training. Widespread deforestation in the San Juan area has led to a reduction in self-sufficient farming and a lack of nutrition evidenced by an increase in infant blindness caused by Vitamin A deficiency. To combat this situation, FUDECO has taught the women's group led by Nisoris how to use solar power to dry fruits and vegetables to preserve them for consumption beyond their season. The pilot group has in turn taught six other women's groups and conducted informal product sampling and Vitamin A information sessions in the local market. FUDECO provides supplies and technical expertise. The program has been so successful that the women are exploring packaging options so that they can sell the dried produce.^ieng
Assuntos
Serviços de Saúde Comunitária , Abastecimento de Alimentos , Planejamento em Saúde , Renda , Distúrbios Nutricionais , Organizações , Vitamina A , Mulheres , América , Biologia , Região do Caribe , Conservação dos Recursos Naturais , Atenção à Saúde , Países em Desenvolvimento , Doença , República Dominicana , Economia , Meio Ambiente , Saúde , Serviços de Saúde , América Latina , América do Norte , Fisiologia , Política , Atenção Primária à Saúde , Opinião Pública , VitaminasRESUMO
PIP: The Dietary Management of Diarrhea project in Callejon de Huaylas, Peru is an interdisciplinary effort to reduce or eliminate the nutritional complications of diarrhea in children. A recent government nutrition and health survey showed chronic childhood malnutrition to be a common problem beginning around the time of weaning. Ethnographic studies were then used to provide: 1) specific information on beliefs about diarrhea and child feeding patterns during diarrhea; 2) information to design the questionnaire for the sample survey; and 3) cultural and social information for the educational intervention phase of the program. The sample survey administered to approximately 2500 families with children under 3. Results show diarrhea to be extremely common, with point prevalence rates reaching 20% for children 6-23 months. Breastfeeding was initiated almost universally and continued for a median of about 21 months. However, other liquids were often added unnecessarily to the infant's diet. Solid foods were being received by a majority of infants by 5 months, and by almost all by 9 months. There was no change in foods offered to children with diarrhea. Based on the research, the following activities were proposed for the pilot intervention: 1) development of an improved weaning food of enhanced energy and nutrient density that could be used for the treatment of diarrhea, 2) dissemination of information about these recipes using radio and face-to-face demonstrations in community programs and rural marketplaces, and 3) training health professionals to promote the weaning food. The recipe (eventually named sanquito) was developed with mother from the community, tested within the community for acceptability and clinically with hospitalized children. It was then heavily promoted both to the general public and to health professionals. At the completion of the educational intervention (March-August 1988) it was evaluated by 1) interviews with health professionals about whether they had received and used the promotional materials, 2) a sample survey of 350 households to assess the family's knowledge of sanquito and their trial and adoption rates, and 3) indepth interviews with mothers to identify attitudes concerning sanquito and their reasons for adoption of non-adoption of the recipe.^ieng
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Diarreia Infantil , Diarreia , Educação , Planejamento em Saúde , Fenômenos Fisiológicos da Nutrição do Lactente , Distúrbios Nutricionais , Fenômenos Fisiológicos da Nutrição , Projetos Piloto , Pesquisa , América , Atenção à Saúde , Países Desenvolvidos , Países em Desenvolvimento , Doença , Saúde , Serviços de Saúde , América Latina , Organização e Administração , Peru , Atenção Primária à Saúde , América do SulRESUMO
PIP: In Haiti, more than 755 of the children under 5 are malnourished, the infant mortality rate is about 125/1000. In the 70's, the medical community devised centers d'Education et de rehabilitation nutritionelle (CERNs) which focused on nutritional rehabilitation by education of the mothers. CERNS were very expensive and not very effective because mothers rarely returned for follow-up care and because they treated children who were already malnourished. In the mid-70's, Petit Guave attempted to set up an outreach program similar to the one that the Hospital Albert Schweitzer created. This program included preventative care, nutrition, and family planning services. Workers visited individual families to educate them in health care. Petit Guave paid special attention to children under 5 by keeping growth monitoring records. Infant mortality rates fell by almost 25% and child mortality was halved in this time. Growth monitoring was performed monthly. A lack of supervision caused the initially successful program activities to decline severely. In Bell Anse, volunteers monitored villagers weekly by operating rally posts. This program features extensive participation by the mother and nutritional education discussions. Children were immunized at the rallies. After 12 months, death rates decreased and growth rates increased significantly. Further operational research is needed in the form of supervision, community control, effectiveness of workers, and values of the incentives of the program.^ieng
Assuntos
Desenvolvimento Infantil , Crescimento , Atenção Primária à Saúde/organização & administração , Desnutrição Proteico-Calórica/prevenção & controle , Criança , Pré-Escolar , Agentes Comunitários de Saúde/organização & administração , Haiti , Exposições Educativas/organização & administração , Humanos , Lactente , Recém-NascidoRESUMO
Cuba still has a double burden of health risks. It must contend with some risks to health that persist in underdeveloped rural areas, and it must also deal with the risk factors associated with modern, urban living conditions. The economic and social changes fostered in the postrevolutionary period have reduced the relative importance of the first set of factors, but the changes have also introduced or intensified a myriad of factors derived from their own successes. In this article, the risk factors of greatest concern in contemporary Cuba are described, and the strategies adopted to combat these risk factors, together with the ways in which such strategies are shaped by Cuba's social and economic development are discussed.
PIP: Cuba still has adouble burden of health risks. It must contend with some risks to health that persist in underdeveloped rural areas, and it must also deal with the risk factors associated with modern, urban living conditions. The economic and social changes fostered in the postrevolutionary period have reduced the relative importance of the 1st set of factors, derived from their own successees. Cuba's preventive attention is increasingly concentrated on heart disease, cancer, and stroke. Risk factors related to diet, smoking, obesity, sedentarianism, and occupational accidents are also receiving much attention. 2 types of preventive strategies have been employed to avoid health risks, namely, changing behavior that exposes people to risk and eliminating the risk itself. It is too early to tell how successful Cuba will be in its present campaign to reduce risk factors. The decisive factors for Cuba's current health programs very likely will be the roles of the local governments and of the mass organizations operating at the level of the community and workplace.
Assuntos
Promoção da Saúde , Administração de Serviços de Saúde , Doença Crônica/prevenção & controle , Cuba , Dieta , Nível de Saúde , Humanos , Doenças Profissionais/prevenção & controle , Prevenção Primária , Risco , FumarRESUMO
PIP: This study analyzed the relationships between breastfeeding, nutritional status, and land ownership in a sample of 225 families in an underdeveloped area in Northeast Brazil. According to weight-for-age standards, 51% of the study infants were malnourished and there was a significant inverse correlation between landholdings and malnutrition. At the time of the survey, 51 of the 225 study infants were being breastfed, 65 had never been breastfed, and 109 had been weaned. 52% of the weaned infants had been breastfed for less than 30 days and 71% had received breast milk for less than 60 days. No cases of grade II or III malnutrition were found in the breastfed infants; in contrast, 30% of the bottle-fed infants fell into these categories. There was no significant association between landholding and the duration of breastfeeding. These findings suggest a need to promote proper infant breastfeeding through both primary health care and community participation strategies. Given the correlation between land ownership and infant nutritional status, modification of the existing agricultural structure could prove essential to the success of public health interventions.^ieng