WHO Conference Research Articles

Multilevel interventions as climate change adaptation response to protect maternal and child health: a scoping review protocol

IntroductionGrowing evidence suggests that climate change-related extreme weather events adversely impact maternal and child health (MCH) outcomes, which requires effective, sustainable and culturally appropriate interventions at individual, community and policy...

Fetal scalp stimulation for assessing fetal well-being during labour.

Continuous fetal heart rate monitoring by cardiotocography (CTG) is used in labour for women with complicated pregnancies. Fetal heart rate abnormalities are common and may result in the decision to expedite delivery by caesarean section. Fetal scalp stimulation (FSS) is a second-line test of fetal well-being that may provide reassurance that the labour can continue. To evaluate methods of FSS as second-line tests of intrapartum fetal well-being in cases of non-reassuring CTG. FSS and CTG were compared to CTG alone, and to CTG with fetal blood sampling (FBS). We searched Cochrane Pregnancy and Childbirth's Trials Register (which includes trials from CENTRAL, MEDLINE, Embase, CINAHL, the WHO ICTRP and conference proceedings), ClinicalTrials.gov (18 October 2022), and reference lists of retrieved studies. Eligible studies were randomised controlled trials (RCTs) that compared any form of FSS to assess fetal well-being in labour. Quasi-RCTs, cluster-RCTs and studies published in abstract form were also eligible for inclusion, but none were identified. Two review authors independently assessed studies for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the certainty of the evidence using the GRADE approach. Two trials, involving 377 women, met the inclusion criteria for this review. Both trials were conducted in hospital settings and included women with singleton, term (37+0 weeks or more) pregnancies, a cephalic presentation, and abnormal CTG. Follow-up was until hospital discharge after the birth. A pilot trial of 50 women in a high-income country (Ireland) compared CTG and digital fetal scalp stimulation (dFSS) with CTG and fetal blood sampling (FBS). A single-centre trial of 327 women in a lower middle-income country (India) compared CTG and manual fetal stimulation (abdominal or vaginal scalp stimulation) with CTG alone. The two included studies were at moderate or unclear risk of bias. Both trials provided clear information on allocation concealment but it was not possible to blind participants or health professionals in relation to the intervention. Although objective outcome measures were reported, outcome assessment was not blinded or blinding was unclear. dFSS and CTG versus FBS and CTG There were no perinatal deaths and data were not reported for neurodevelopmental disability at >/= 12 months. The risk of caesarean section (CS) may be lower with dFSS compared to FBS (risk ratio (RR) 0.38, 95% confidence interval (CI) 0.16 to 0.92; 1 pilot trial, 50 women; very low-certainty evidence) but the evidence is very uncertain. There were no cases of neonatal encephalopathy reported. The evidence was also very uncertain between dFSS and FBS for assisted vaginal birth (RR 1.44, 95% CI 0.76 to 2.75; very low-certainty evidence) and for the spontaneous vaginal birth rate (RR 2.33, 95% CI 0.68 to 8.01, very low-certainty evidence). Maternal acceptability of the procedures was not reported. FSS and CTG versus CTG alone Manual stimulation of the fetus was performed either abdominally (92/164) or vaginally (72/164). There were no perinatal deaths and data were not reported for neurodevelopmental disability at >/= 12 months. There may be little differences in the risk of CS on comparing manual fetal stimulation and CTG with CTG alone (RR 0.83, 95% CI 0.59 to 1.18; 1 trial, 327 women; very low-certainty evidence), but again the evidence was very uncertain. There were no cases of neonatal encephalopathy reported. There may be no differences in the risk of assisted vaginal birth (RR 1.43, 95% CI 0.78 to 2.60; very low-certainty evidence) or in the rates of spontaneous vaginal birth (RR 1.01, 95% CI 0.85 to 1.21, very low-certainty evidence), but again the evidence is very uncertain. Maternal acceptability of abdominal stimulation/FSS was not reported although 13 women withdrew consent after randomisation due to concerns about fetal well-being. There is very low-certainty evidence available which makes it unclear whether stimulating the fetal scalp is a safe and effective way to confirm fetal well-being in labour. Evidence was downgraded based on limitations in study design and imprecision. Further high-quality studies of adequate sample size are required to evaluate this research question. In order to be generalisable, these trials should be conducted in different settings, including broad clinical criteria at both preterm and term gestational ages, and standardising the method of stimulation. There is an ongoing study (FIRSST) that will be incorporated into this review in a subsequent update.

Male partner unknown HIV status as a risk factor for HIV incidence and clinical outcomes in prevention of mother-to-child transmission of HIV programmes in 21 WHO priority countries: a systematic review protocol

IntroductionResearch has shown an association between increased disclosure of HIV status by pregnant and breastfeeding women and improved clinical health and that of their infant. Increasing awareness about their male...

Socioeconomic status and occurrence of chronic pain: a meta-analysis.

To examine the association between socioeconomic status (SES) and the occurrence of chronic pain, defined as pain that persists or recurs for >3 months. We performed a structured search in Medline, Embase, WHO Global Index Medicus and Conference Proceedings Citation Index-Science databases to identify cohort and case-control studies on chronic pain and SES and its subgroups (SES combined index, educational level, income and occupational status). We extracted study characteristics, outcome measures and measures of association and their 95% CIs. Literature search, data extraction and risk of bias assessment were conducted by two independent researchers. We performed main and subgroup meta-analyses using random-effects model, and formally assessed heterogeneity and publication bias. A total of 45 studies, covering a population of ∼175000 individuals, were meta-analysed, yielding a pooled Odds Ratio (OR) of 1.32 (95% CI: 1.21, 1.44) and 1.16 (95% CI: 1.09, 1.23) for low and medium SES levels, respectively, compared with high level. We obtained similar results in all the subgroup analyses. Heterogeneity was generally moderate to high across strata, and some evidence of publication bias for low socioeconomic status was found. Our results support a moderate increase in the risk of chronic pain for low and medium SES when compared with high SES, a feature that remained constant in all measures of exposure or outcome used. Further prospective research on populations from developing countries are needed to confirm our findings as the studies available for this meta-analysis were carried out exclusively in developed countries.

Strengthening health promotion research

Abstract Neither the Ottawa Charter nor any other WHO Conference declarations mention research and its role as a driver of health promotion practice. As a result, health promotion is often perceived as a discourse based on principles and values, an ideology that lacks scientific rigour. Despite this lack of recognition in health promotion documents, there is a burgeoning research domain that labels itself health promotion. The growing number of journals that publish empirical studies related to health promotion, the growing number of research training programs with a subspeciality in health promotion, and the growing number of research infrastructure (research chairs, research centres, institutes and so on) are all sure signs of a thriving research enterprise. However, these are institutionally disparate and dispersed in various disciplinary such as: education, public health, psychology and others. Up to now, health promotion research has followed what one could call “potluck” a development model. In this model, interested individuals come with their own piece of empirical study, anchored in their disciplinary perspective, and the study is labelled health promotion essentially because they have decided to label it this way. As a result, the field of health promotion research also appears as disparate, wherein various and even contradictory epistemological and ethical perspectives are present. In this presentation, we will argue that health promotion as a practice and as policy systems would benefit from a stronger and more unified field of health promotion research, to the extent that research creates knowledge based on these practices and policy systems. Using a sustainability framework, we will show how research reinforces the conditions for the sustainability of health promotion practice and systems and we will propose some methodological and ethical principles with the potential to strengthen the positive and mutual benefits of health promotion research and practice.

Performance-based financing for improving HIV/AIDS service delivery: a systematic review

BackgroundAlthough domestic HIV/AIDS financing is increasing, international HIV/AIDS financing has plateaued. Providing incentives for the health system (i.e. performance-based financing [PBF]) may help countries achieve more with available resources. We systematically reviewed effects of PBF on HIV/AIDS service delivery to inform WHO guidelines.MethodsPubMed, WHO Index Medicus, conference databases, and clinical trial registries were searched in April 2015 for randomised trials, comparative contemporaneous studies, or time-series studies. Studies evaluating PBF in people with HIV were included when they reported service quality, access, or cost. Meta-analyses were not possible due to limited data. This study is registered with PROSPERO, number CRD42015023207.ResultsFour studies, published from 2009 to 2015 and including 173,262 people, met the eligibility criteria. All studies were from Sub-Saharan Africa. PBF did not improve individual testing coverage (relative risk [RR], 1.00, 95% confidence interval [CI] 0.89 to 1.13), improved couples testing coverage (RR 1.11, 95% CI 1.02 to 1.20), and improved pregnant women testing coverage (RR 1.29, 95% CI 1.28-1.30). PBF improved coverage of antiretrovirals in pregnant women (RR 1.55, 95% CI 1.50 to 1.59), infants (RR 1.92, 95% CI 1.84 to 2.01), and adults (RR 1.74, 1.64 to 1.85). PBF reduced attrition (RR 0.84, 95% CI 0.74 to 0.96) and treatment failure (odds ratio 0.55, 95% CI 0.32 to 0.97). Potential harms were not reported.ConclusionsAlthough the limited data suggests PBF positively affected HIV service access and quality, critical health system and governance knowledge gaps remain. More research is needed to inform national policymaking.

American Mock World Health Organization (AMWHO): introducing students to global health policy through a model WHO conference

4 www.thelancet.com/lancetgh Published Online April 8, 2016 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA (E Lee, M Lei, E Holcomb) Correspondence to: Emma Holcomb, University of North Carolina at Chapel Hill, American Mock World Health Organization, Box 8 Frank Porter Graham Student Union, UNC-CH Campus Box 5210, Chapel Hill, NC 27599-5210, USA emmach@live.unc.edu American Mock World Health Organization (AMWHO): introducing students to global health policy through a model WHO conference Edith Lee, Mia Lei, Emma Holcomb Abstract Background The American Mock World Health Organization (AMWHO) was established in 2013, and between October 2-4, 2015, the second AMWHO conference convened at the University of North Carolina, Chapel Hill, NC, USA. The aim of AMWHO is to engage students in health policy, empower future global leaders through simulations of WHO meetings, allow students to practise their knowledge of global health, and sharpen their skills in diplomacy, communication, problem solving, and confl ict resolution. Here, we describe the AMWHO and report outcomes for delegates at the 2015 conference.Background The American Mock World Health Organization (AMWHO) was established in 2013, and between October 2-4, 2015, the second AMWHO conference convened at the University of North Carolina, Chapel Hill, NC, USA. The aim of AMWHO is to engage students in health policy, empower future global leaders through simulations of WHO meetings, allow students to practise their knowledge of global health, and sharpen their skills in diplomacy, communication, problem solving, and confl ict resolution. Here, we describe the AMWHO and report outcomes for delegates at the 2015 conference. Methods AMWHO recruited delegates through marketing to universities and social media. The 2015 conference was structured as a model conference; each student represented a WHO member nation to debate, and write resolutions on, the conference’s theme—universal health coverage in 2015. After the conference, we surveyed delegates at AMWHO 2015 to seek feedback on their experience at the meeting . Findings AMWHO 2015 was attended by 113 undergraduate and graduate students from the USA and other countries. Students heard from experts in global health through lectures, lunch-and-learns, and panel discussions. We analysed 39 feedback forms and attendees described an overwhelmingly positive experience of the conference. Students said AMWHO had “revived [their] passion for diplomacy and advocacy,” and described the experience as one that “could not be found in a classroom” and “infl uential” for their future plans. 35 of 39 respondents (90%) rated the experience as “good” or better, and 38 of 39 (97%) would recommend AMWHO to a friend. Resolutions from the conference were sent to WHO in Geneva, Switzerland. Interpretation AMWHO is a useful forum for students to improve their knowledge of global health issues, and sharpen their skills in diplomacy, communication, problem solving, and confl ict resolution. Emory University (Atlanta, GA, USA) will host the next national AMWHO conference in October, 2016. Eight AMWHO chapters have been established at other universities, and a network has been formed to facilitate growth. AMWHO at the University of North Carolina will expand to be a year-round organisation on campus that focuses on global health policy.

Primary Prevention of Obesity and Type 2 Diabetes Mellitus

The prevalence of type 2 diabetes mellitus has exceeded 22million people in Europe and according to WHO, it will increase from 135 million in 1935 to 300 million in 2025. In 1989 Saint Vincent Declaration, elaborated by the International Diabetes Federation (IDF) called all the European countries to take action aimed at reducing the prevalence of type 2diabetes mellitus and its complications on the population level. Poland has signed the Declaration within the “Polish Multicenter Study in Diabetes Epidemiology (PMSD) program (implemented in the cities of Krakow, AA¯Â?½odAo, and Lublin), financed by the Ministry of Health, and developed within the years of 1998– 2000. The program was coordinated by the Chair and Department of Endocrinology, Jagiellonian University, Collegium Medicum in Krakow. It revealed over 2 million diabetics in Poland, half of which represented the so-called unknown diabetes, diagnosed for the first time in the course of investigation. The prevalence of type 2 diabetes mellitus is still growing up owing to the increasing prevalence of its main risk factors: overweight and obesity, mainly the visceral type. The basic method of preventing of the type 2 diabetes mellitus within the PMSD is body weight reduction with an increase in physical activity and an appropriate educational program. The second basic goal of the program in the highest risk group of type 2 diabetes mellitus is to decrease blood pressure in hypertensive patients. Hypertension management is based on salt intake reduction, however, salt is the main carrier of iodine in the iodine prophylactic system in Poland so iodine must be additionally supplemented with additional carriers, such as milk or iodized mineral water: “Ustronianka” “Jodavit” or “Wysowianka”. The results of the program point out that the process of type 2 diabetes mellitus formation is reversible, but under the condition of early intervention. Additional parts of the program are economic burden evaluation and resort management. The resort of “Wysowa S.A.” has already been prepared to implement prevention and management in patients with overweight, obesity, and type 2 diabetes mellitus. On July 4-5, 2013, the International Ministerial Conference in Vienna took place. It was the first conference in the context of the “Global Plan of WHO Action in Prevention and Control of Non-communicable Diseases 2013-2020” (Health 2020) program, approved of by the 66th World Health Assembly and the 8th Global WHO Conference on Health Promotion in Helsinki. The conference also resulted in issuing the Vienna Declaration, which points at continuing the Ministerial Conference on Counteracting Obesity that took place in Istanbul in 2006. The documents raised the problems of healthy food and preventing food-related non-communicable diseases, as well as lead the way to renew the WHO “Action Plan for Food and Nutrition Policy” program, which expired in 2012.

Education and Religious Beliefs: Supportive Determinants in the Understanding of Health Issues in Sub-Saharan Africa

In the aftermath of the 1978 WHO conference where the Alma Ata Declaration on primary health care was issued, the Cameroonian government was striving to guarantee equity in health care by developing a policy targeting social justice and assurance of health for by 2000s. From this, a research programme based on health in the urban milieu was conceived in 2000 to address the population's state of health. The epidemiological and transversal study was carried out in April-May 2005 on children aged between 6 and 59 months in Yaounde (Cameroon). The objectives of this study were to identify risk factors predisposing people to diarrheas in the city, to measure their prevalence, and ascertain their spatial distribution, all in a bid to evaluate the progress made in infant health since 1978. The microbiological analyses carried out revealed an average diarrhea prevalence rate of 14.4% (437 cases of diarrhea on the 3034 infants tested). Amongst many other factors, the level of education and the religious belief of the household head were seen to be associated with the occurrence of infants' diarrhea. In addition, it was acknowledged that the level of diarrhea infection in the city varies considerably from one household to another.

Increased Mitochondrial Mass and Mitochondrial DNA Copy Number Are Biomarkers for Benzene Exposure in Hematopoietic Tissue and Leukemia Cells.

Abstract 4426 BackgroundExposure to benzene and its metabolites increases risk of marrow failure disorders, leukemia and other hematological diseases. However, biomarkers of benzene toxicity have not been comprehensively studied in hematopoietic cells and leukemia cells. We previously reported that benzene metabolites may impair electron chain transport and mitochondrial function (3rd WHO Conference on Children's Health and the Environment, 7-10 June 2009). Therefore, we hypothesized that alterations in mitochondrial mass and mitochondrial DNA (mtDNA) may occur in bone marrow cells and leukemia cells after benzene exposure to compensate for damaged mitochondria. Materials and MethodsTotal bone marrow cells from healthy individuals and leukemia cell lines (THP-1, Kasumi-1, K562, Molt-4 and HL-60) were cultured in RPMI media containing 10% fetal bovine serum for 5 days. Benzene was added in cell culture media with 0, 1 and 10mM concentration at 24 hour interval. Cell count was performed using an automated blood cell analyzer (ADVIA120, Siemens, Germany). Viability and apoptosis were assessed by tryptophan blue dye exclusion test and flowcytometry based annexin V staining protocol. Hydrogen peroxide content is measured using the commercial kit (Bioxytech® H2O2-560TM, OXIS International) according to the manufacturer's instructions. Mitochondrial mass, membrane potential and mtDNA copy number were measured using MitoTracker Green, MitoTracker Red probes (Invitrogen), and real time PCR using the QuantiTect SYBR Green PCR kit (Qiagen) and Rotor-Gene 3000 (Corbett Research), respectively. ResultsThe number of cells were gradually increased regardless of concentration of benzene in day 3, and then steadily maintained during 3 weeks culture. Interestingly, the growth of K562 cells showed no growth inhibition effect (three fold increase) after 5-day exposure to benzene. Overall viability of five leukemia cell lines disclosed significant decrease after two week treatment of benzene (about 60% of viability was observed in 3- week suspension culture). The proportion of apoptosis was increased in time and dose dependent manner after 2-week treatment of benzene. Interestingly, mitochondrial contents and membrane potentials were dramatically increased in 3-week suspension culture after benzene exposure at dose dependent manner. The level of hydrogen peroxide significantly elevated after two week treatment of benzene (4.4 ± 1.9 μM/mg protein) compared with non-benzene treatment group (1.2 ± 1.0 μM/mg protein; P = 0.001). The average mtDNA copy number was gradually increased after exposure to benzene. ConclusionsBenzene exposure caused increased mitochondrial mass and mtDNA copy number in response to oxidative stress induced by benzene. So, these mitochondrial changes can be used for biomarkers of benzene toxicity in hematopoietic tissue and leukemia cell. Disclosures:No relevant conflicts of interest to declare.

Women's health and prisons: it's time for urgent action. A report from the WHO Health in Prisons Project Annual Conference 'Prisons and Women's Health' 13 November 2008, Kiev, Ukraine.

The strongest international recognition of the importance of women's health in prisons and the urgent need for radical change was highlighted of a WHO Conference held recently in Kiev, Ukraine.

SARS Special Report — Conference

WHO Announced Success in SARS Containment but Warned against Complacency. SARS Scientists Gather in Singapore for WHO Conference.

Common conditions of the aging male: erectile dysfunction, benign prostatic hyperplasia, cardiovascular disease and depression.

With increasing life expectancy, medical profession will be faced with the task of ensuring that the large, aging population remains healthy and vital despite the face of increasing healthcare costs. Naturally, urology as a specialty is concerned with important geriatric issues. This article will focus specifically on the aging male population and the health problems that most frequently plague them. Four major, non-cancer, disease states have been identified that adversely effect males over the age of 50. These conditions are: erectile dysfunction (ED), benign prostatic hyperplasia (BPH), cardiovascular disease (CVD) and depression. A literature search of PubMed was conducted using the key words ED, BPH, CVD and depression as well as ADAM (Androgen Decline in the Aging Male) and quality of life (QoL). NIH and WHO conference proceedings and publications were also referenced to insure detail and accuracy of data. Information was then organized and correlated in order to provide a detailed description of the key conditions and their interrelatedness. The spectrum of research performed thus far regarding this topic has done little to investigate the effects, causes and correlations between these conditions. Research has been done linking two or three of these conditions; however, there remains to be information discussing the four disease states in terms of their possible cause and effect relationships or the effectiveness of parallel, multi-disciplinary approach to their therapy. This report calls attention to the benefits of viewing and researching the above mentioned conditions as possibly interrelated, as opposed to the traditional view of them as separate, unrelated and independently treatable disease states. ED, BPH, CVD and depression are all common conditions that accompany aging and negatively impact QoL. They almost always develop with age and precipitate considerable morbidity and may even result in mortality. Furthermore, the presentation of one condition may correlate with the development of another. The inter-relation of these conditions, as evident from their underlying similarities, cause-and-effects relationships and therapeutic consequences, should be enough to warrant a multidisciplinary approach to their research. This approach, combined with careful choice of therapy, parallel and singular, will help providers reach their goal to keep patients healthy, and more importantly happy, late into their life, thus realizing the concept of "successful aging".

Do we still need mental hospitals?

“The debate is over” claimed a heading in a newspaper on the 1991 Amsterdam WHO conference ‘Changing mental health care in the cities of Europe’: “After half a century of debate of the issue of deinstitutionalisation the question is not any more if we should close the large mental hospitals, but what follows the closure and how to develop adequate community mental health care which replaces the functions of the mental hospital” (Gersons & Burns, 1992).These ‘functions’ have actually secured the long-lasting success of the mental hospital which has been in the past and, to a certain extent, still is in a number of countries, the cornerstone of psychiatric care. It incorporates all the functions of a psychiatric system in a single, usually isolated facility, including crisis intervention, evaluation, treatment, aftercare, long-term custodial care, rehabilitation, etc. In order to phase down the mental hospital these functions have to be supplemented by newly established, discrete services disseminated in the community. The process is clearly a complex one, since it implies a transition from a system of care provided only in mental hospitals under medical direction, to one that is comprehensive in scope, community-orientated, and staffed by multidisciplinary teams.

Health, society and alcohol

AddictionVolume 91, Issue 6 p. 749-752 Free Access Health, society and alcohol Peter Anderson, Peter Anderson World Health Organization Regional Office for Europe, 8 Scherfigsvej, DK-2100 Copenhagen, DenmarkSearch for more papers by this author Peter Anderson, Peter Anderson World Health Organization Regional Office for Europe, 8 Scherfigsvej, DK-2100 Copenhagen, DenmarkSearch for more papers by this author First published: June 1996 https://doi.org/10.1080/09652149639961AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1 Health for all Targets (1993) The Health Policy for Europe, European Health for All Series, No. 4 (Copenhagen, WHO Regional Office for Europe). 2 Anderson, P. &Lehto, J. (1995) Evaluation and Monitoring of Action on Alcohol, European Series, No. 59 (Copenhagen, WHO Regional Office for Europe). 3 Edwards, G., Anderson, P., Babor, T. F. et al. (1994) Alcohol Pohcy and the Public Good ( Oxford , Oxford University Press). 4 Harkin, A.-M, Anderson, P. & Lehto, J. (1995) Alcohol in Europe-a health perspective ( Copenhagen , WHO Regional Office for Europe). 5 World Health Organization (1996) Alcohol and Health-implications for public health policy document ( Copenhagen , WHO Regional Office for Europe). 6 World Health Organization (1993) European Alcohol Action Plan (document ICP/ADA 035)(Copenhagen, WHO Regional Office for Europe). 7 H. D. Holder & G. Edwards (Eds) (1995) Alcohol and Public Policy: evidence and issues ( Oxford , Oxford University Press). 8 Edwards, G. (1995) Alcohol Policy and the Public Good: an international debate, (Addiction Special Publication) (Abingdon, Carfax Publishing Company). 9 Lehto, J. (1995) Approaches to Alcohol Control Policy, European Series, No. 60 (Copenhagen, WHO Regional Office for Europe). 10 Lehto, J. (1995) The Economics of Alcohol Policy, European Series, No. 61 (Copenhagen, WHO Regional Office for Europe). 11 Montonen, M. (1995) Alcohol and the Media, European Series, No. 62 (Copenhagen, WHO Regional Office for Europe). 12 Ritson, B. (1995) Community and Municipal Action on Alcohol, European Series, No. 63 (Copenhagen, WHO Regional Office for Europe). 13 Anderson, P. (1995) Alcohol and Primary Health Care, European Series, No. 64 (Copenhagen, WHO Regional Office for Europe). 14 Heather, N. (1995) Treatment Approaches to Alcohol Problems, European Series, No. 65 (Copenhagen, WHO Regional Office for Europe). 15 Anderson, K. (1995) Young people and alcohol, drugs and tobacco, European Series, No. 66 (Copenhagen, WHO Regional Office for Europe). 16 Henderson, M., Hutcheson, G. & Davies, J. (1995) Alcohol and the Workplace, European Series, No. 67 (Copenhagen, WHO Regional Office for Europe). 17 Hannibal, J. U., van Iwaarde, M. J., Gefou-Madianou, D., Moskalewicz, J., Ritson, B. & Rud, M. G. (1995) Alcohol and the Community ( Copenhagen , WHO Regional Office for Europe). 18 Hvalkof, S. & Anderson, P. (1995) Terminology for the European Conference on Health, Society and Alcohol ( Copenhagen , WHO Regional Office for Europe). 19 Department of Health (1995) Sensible Drinking ( London , Department of Health). 20 Eurocare(1995) A Guide for Action-a summary of alcohol policy and the public good ( Saint Ives , EUROCARE). 21 Eurocare (1995) Statement of non-governmental organizations to the WHO conference on health, society and alcohol. Available from: EUROCARE, 1 The Quay, Saint Ives, Cambridgeshire PE17 4AR. Volume91, Issue6June 1996Pages 749-752 ReferencesRelatedInformation

Financial information at district level: experiences from five countries

Management information systems are intended to help managers made decision. But few management information systems in primary health care include information on costs even though resource allocation and budgeting are key functions of primary health care managers. Drawing on 5 papers presented to a WHO conference on strengthening district health systems this article illustrates the potential usefulness of financial data to district managers. The examples come from individual districts in Ethiopia Indonesia Kenya Sri Lanka and Tanzania. No original data were collected for the studies; much can be learned from budgets and expenditure ledgers. Some problems were encountered with the reliability of the data; a particular confusion was between allocated and realized budgets. Allocated budgets are a stated intention to spend money; realized budgets show that the expenditure actually occurred. For planning purposes realized amounts are of more interest. Managers can use financial information to question the allocation of resources in various ways. Providing information on how much is being spent on what activities enables an explicit consideration of the desirability of the existing use of resources relative to priorities. Comparing unit costs can raise questions about the relative efficiency of different units be they health centers vaccinations points or wards. Looking at the distribution of resources according to geographical areas or other ways of grouping people provides background data for the consideration of equity. Finally the paper discusses how financial information might be used to identify areas of wastage. The paper concludes that health systems already produce a good deal of financial information. At present however this information is often only used by accountants or finance officers. Financial information should be incorporated into the larger management information system. (Authors).

Problems in Assessing Airborne Man-Made Mineral Fibre Concentrations in Relation to Epidemiology

Abstract The results of airborne dust measurements undertaken in the European MMMF manufacturing industry in conjunction with a retrospective epidemiology study were reported at a WHO conference in 1982. Subsequently, a reference scheme was instigated to develop reference evaluation procedures for use in epidemiology and to harmonise interlaboratory differences using these methods. These developments have resulted in an increase in the reported fibre concentrations for the above study by approximately three times. Estimates of the average airborne respirable fibre concentrations for combined occupational groups in glasswool manufacture ranged from Information about the technical history of the factories has been obtained and the validity of using current fibre concentrations to estimate workers' past exposure is discussed. Three changes in production have been identified as having a potentially important effect on fibre levels: nominal fibre size, addition of oil to MMMF and labour intensive batch production techniques. It has been estimated that changes in these parameters may have reduced fibre levels by up to ten times. Based on the plant technical histories the production at each factory has been divided into three phases for use in the epidemiological analysis described in another paper at this symposium.

International WHO conference for Adelaide

Medical Journal of AustraliaVolume 146, Issue 51 p. MP10-MP10 Healthy Public Policy International WHO conference for Adelaide First published: 01 March 1987 https://doi.org/10.5694/j.1326-5377.1987.tb112764.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume146, Issue51March 1987Pages MP10-MP10 RelatedInformation

Issues in the political economy of health in Southern Africa.

Over the past few years there have been major political developments in southern Africa. In the Republic of South Africa, the National Party's short-lived reformist strategy designed to buy off black discontent and to restructure apartheid in order to meet the changing demands of the economy has simply further fuelled black aspirations for their legitimate share of political and economic power. While some of the reforms may change the character of apartheid, South Africa's rulers have shown themselves to be as determined as ever to maintain white domination and their economic and political control of the sub-continent. They are neither willing nor able to engage in negotiations over genuine power-sharing, as the failure of the Commonwealth Eminent Persons Mission and the declaration of a fresh State of Emergency in the Republic on the 12th July 1986 have dramatically illustrated. Commonwealth hopes for a peaceful settlement were brought to an abrupt end by South Africa's military assault on the states of Zimbabwe, Zambia and Botswana. The Republic's onslaught against its neighbours reveals the intrinsic connection between apartheid and the well-being of people in the surrounding states. In the countries of the sub-continent and in South Africa itself these political and economic developments have had their repercussions in the health sphere. Violence and preventable diseases have taken an increasing toll, yet fewer resources are available for dealing with them as military preparations swallow up vast sums of money. In our report to the WHO conference on health and apartheid held in Brazzaville in 1981, we talked of the hidden violence in South Africa: the decimation of the black population by preventable diseases of infancy; the systematic destruction of family life and human health under the migrant labour system; the inadequate protection of workers' lives and safety; the deep insecurity and violence of township life; and the humiliation and degradation forced upon the majority of the population as second class citizens. 1 All these forms of violence have continued unchanged, deepened if anything by the current civil war. Despite the talk of reform, and limited changes in legislation, the racial discrepancies in the incidence of the diseases of poverty and deprivation such as tuberculosis, malnutrition and associated infections have if anything become starker. Although the South African state adopted as rhetoric many of the recommendations of the WHO Alma Ata conference on primary health care,

International classification of primary care.

"Health for all by year 2000" was the subject of the WHO Conference at Alma-Ata in 1978. It was evident that good primary care was a requirement to reach this goal. However, knowledge about this was scanty, and the instrument, an acceptable classification for analyses of primary care, was lacking. Since 1978 a WHO Working Party on Classifications of Primary Care has been working on a Reason for Encounter Classification. A RFEC test form was produced. In 1983 a feasibility study was conducted in nine countries: Australia, Barbados, Brazil, Hungary, Malaysia, The Netherlands, Norway, the Philippines, and the USA. The results of this were changing the original proposal very much. In addition, the WONCA/WHO Classification of Health Problems in Primary Care was included in the final version. In 1984 this final version was accepted by WONCA Classification Committee. This is called ICPC = The International Classification of Primary Care. ICPC is biaxial with the chapters of organ/organ systems along the one axis, in addition of three chapters: General, Mental, and Social problems. The other axis comprises seven components: Complaints, Process and Diagnosis. An alphanumeric code is used. The feasibility study of RFEC comprised ten test sites, and 138 primary care professionals recorded a total of 100 452 reasons for encounter. The English version of the RFEC was translated into five other languages, and these versions were used during the study. ICPC is a comprehensive, simple and practicable classification which can be used in medical records and in different areas of primary care research.