Social science & medicine
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The MCH/FP services for women in Africa offer today limited services that do not cater to the multiple and complex problems that women face during their long productive lives. Many women are infertile, many suffer and die from abortions, many cannot get access to safe contraceptive technology or safe and sterile delivery services. ⋯ The health needs of women have thus intensified and become increasingly shaped by their growing role in production and in the social reproduction of the household. The paper examines the changing health needs of women in East Africa, why MCH/FP health services have failed to meet these needs, and identifies the types of services that women increasingly require.
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Social science & medicine · Jan 1989
ReviewWar-related changes in health and health services in Nicaragua.
The low-intensity war against Nicaragua from 1983 to 1987 has had a wide reaching impact on health, health services, and health economics in that country. Beyond the death of individuals and destruction of facilities, economic embargo and contra destruction have cost the health system about 200 billion cordobas between 1981 and 1987. This is approximately equal to the value of 2 years of the entire health budget. ⋯ Nonetheless, the indirect effects of the war have been detrimental to the system. Negative effect include the loss to the system of health professionals and rampant inflation. These forces contribute to the weakening of primary health programs and the reorientation of the national system into hospital based, curative medical services.
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Social science & medicine · Jan 1987
ReviewThe political abuse of medicine and the challenge of opposing it.
A fundamental aim of medicine is to protect and promote health. The practice of medicine has, however, been used to promote political aims which may be detrimental to health. The article attempts to isolate the ways in which political abuses may interfere with good medical practice: by allowing health policies to be influenced by undemocratic political considerations; by using health services to reward or punish political supporters or opponents; by direct medical involvement in political acts which contradict accepted medical ethics; and by the support which conventional medical practises give to perpetuating inequalities in health and social services. ⋯ The ways in which medical personnel have opposed the political abuse of medicine is explored by a brief review of the opposition of Chilean doctors to torture, the involvement of South African doctors in opposing the abuse of health services in perpetuating apartheid, and the growing medical movement in opposition to nuclear war. Some comments concerning the monitoring of a multitude of medical disciplines which are open to political abuse are made. The purpose of the paper is primarily to stimulate debate around this important issue and it does not attempt to provide a comprehensive review of the political abuse of medicine.
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Social science & medicine · Jan 1987
ReviewPsychological research and chronic low back pain: a stand-still or breakthrough?
Some of the main psychological research topics concerning chronic low back pain (CLBP) are critically discussed. These topics include: 1. research aimed at describing a specific low back pain personality profile, 2. research into the predictability of therapy results on the basis of psychological assessment, and 3. outcome research of psychologically-oriented treatment for CLBP. It is concluded that these topics provide little insight into the role of psychological factors in the development and maintenance of CLBP. ⋯ Discussed are: 1. Risk factors in the transition from acute to chronic LBP, 2. the deviant sensitivity to acute, experimental pain stimuli of CLBP patients, 3. the relationship between CLBP behavior and psychophysiologic variables, 4. determinants of CLBP behavior, with special attention to endurance, 5. the deviant processing of proprioceptive stimuli, and 6. the implementation for chronic pain of the unpredictability and uncontrollability paradigms. The emphasis in the presentation of these new topics is more on raising questions than on answering them.
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Social science & medicine · Jan 1986
ReviewUnemployment, health and health services in German-speaking countries.
The links between unemployment and health are manifold: Employment may lead to illness: health problems (that may lead to unemployment) often result from unfavourable working conditions of the (previous) employment. Another factor is job insecurity: fear of job loss increases the incidence of disease, and this applies not only to people who are emotionally unstable. Illness may lead to unemployment: in many cases, unemployment is caused by previous health impairments, which, to a considerable extent, also explain the duration of unemployment. ⋯ Individual prevention and rehabilitation measures are of great importance to problem groups suffering from cumulative or indirect unemployment, i.e. to unemployed elderly as well as to children of unemployed parents. Since the unemployed tend to isolate themselves, extramural services are useful. Specific services for the unemployed only are certainly not as helpful as multi-functional social services, such as those being already rendered by some self-help organizations, churches and trade-unions.(ABSTRACT TRUNCATED AT 400 WORDS)