Articles: community-health-services.
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Pakistan's health characteristics are worse than those of other Asian countries at similar stages of development. Its mortality rate for children under five is 139 per 1,000, and its maternal mortality is 60 per 10,000. Malnutrition in women and children is widespread; 50 per cent of children under five are stunted. ⋯ Partly because the training of doctors and nurses is lengthy and expensive, there is an acute shortage of health care providers, especially women. Although female health professionals are preferred for caring for women, cultural constraints inhibit women from seeking education. Such is the multifaceted dilemma in the provision of primary health care in Pakistan.
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Ann Trop Med Parasit · Apr 1997
ReviewIs there a place for traditional midwives in the provision of community-health services?
Traditional midwives (TM) have been involved in delivering babies, and providing a broad range of other services to women, for hundreds of years. They are usually local women with little formal education. As they are well known in their communities they are often called to assist women at the time of delivery. ⋯ Rather, the studies have shown that the success of the programmes depends on the resources available, the people involved in the training and how the training is carried out. Some of the lessons learnt from working with TM apply to any two groups of people working together. If TM are going to be offered training, and this must be a local decision made after consultation and an evaluation of prevailing resources and conditions, the training should be a two-way process, with both parties learning from each other.
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The education of students in medicine, nursing, pharmacy, and dentistry in the seven health professions schools of the University System of West Virginia has undergone remarkable changes since 1991 to become more responsive to community needs. The changes have also enabled the schools to remain in sync with other anticipated changes in health care delivery. A primary care, community-based academic system has been developed, and students, campus-based faculty, community-based field professors, and lay community members collaborate to identify and resolve problems important to the communities located in the 42 counties designated Under-served Health Professions Service areas, and five additional rural counties. ⋯ The five-years demonstration project that began the new system started in 1991 with four rural sites. By 1996, the system had expanded greatly and consisted of 13 consortia of communities with a total of over 100 rural primary care centers plus several small rural hospitals, public health departments, and other health and social services agencies. The 1996 West Virginia legislature approved funds for the higher education budget that will support and sustain this primary care, community-based academic system.
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The concept of the primary health-care team involving an increasingly diverse range of health care professionals is widely recognized as central to the pursuit of a primary care-led health service in the UK. Although GPs are formally recognized as the team leaders, there is little by way of policy prescription as to how team roles and relationships should be developed, or evidence as to how their roles have in fact evolved. Thus the notion of the primary health-care team while commonly employed, is in reality lacking definition with the current contribution of practice managers to the operation of this team being poorly understood. ⋯ Drawing on questionnaire data, reinforced by qualitative data from the current interview phase, describes the role played by practice managers in differing practice contexts. This facilitates a discussion of a set of ideal type general practice organizational and managerial structures. Discusses the relationships and skills required by practice managers in each of these organizational types with reference to data gathered to date in the research.