World Health & Population
From the Editor-in-Chief
Of the seven papers in this volume, four are from sub-Saharan Africa, three are from South Asia, and one is a multinational comparison. All relate to the impact of poverty and human development on health, and all address issues of importance to work toward achieving the objectives of the Millennium Development Goals.
The first paper in this volume examines the potential risk factors for developing complications during pregnancy. Chowdhury et al. reanalyze a relatively old cross-sectional survey on maternal morbidity in Bangladesh, and put the results in the context of supporting the MDG in this area. Complications are classified by Chowdhury et al. as either "life threatening" or "high-risk" and based upon the data the authors encourage better prenatal health education and social mobilization to reduce the incidence and prevalence of these negative factors.
Idowu and colleagues from the Nigerian Institute of Medical Research address a logistical and training issue in the delivery of health care in "Height as a Substitute for Weight for Estimating Praziqantel Dosage." Proper dosage of drugs is critical not only for efficacy but also safety. Establishing acceptable, simple dosing methods, however, can be a great advantage when training opportunities are scarce, and specialized equipment is difficult to acquire and maintain. Idowu et al.'s study show the adequacy of a measuring stick, versus more complex weight measurement, in determination of proper praziquantel dosage for treatment of schistosomiasis. (Note that even a simple weight scale is considered "specialized equipment"!)
Most current programs to improve child survival focus on the child, e.g., improved nutrition, control of diarrhea and acute respiratory infections, use of vaccinations, etc. Working out of the Aga Khan University in Pakistan, Nuruddin and her coauthors examine through a cross-sectional survey what might be described as a second-order effect: maternal good health and freedom from chronic illness. Their working hypothesis could be paraphrased as "healthy moms lead to healthy kids" and they advocate for more focus on maternal health care in the overall goal of reducing under five child mortality.
The need to prioritize scarce health care resources is necessary for all economies, whether highly resource constrained or not. In the latter economies, however, this need is obviously more pronounced. Uzochukwu and colleagues from the University of Nigeria College of Medicine explore household perceptions and prioritization of endemic diseases through a cross-sectional survey of 16 communities. Interestingly, the survey revealed large discrepancies between community perceptions and the Nigerian government's own epidemiologic and statistical data on disease prevalence and impact. Community education is needed to better align community perceptions with scientific reality; however it is a fine line, in that community perceptions and priorities must also be acknowledged and respected.
In his paper, Binod Nepal provides a multinational ecological and structural analysis of the HIV/AIDS epidemic, discussing the issue of gender balance among those afflicted, and the relationship with the level of socio-economic development and good governance. There is a strong correlation between poverty (whether in developed or resource-constrained economies) and the proportion of women affected by the epidemic. Nepal argues that enhanced gender equity will reduce unsafe exposure to the epidemic, and that well-governed, prosperous societies, working toward gender equity, are necessary for controlling the disease.
Dongre et al. present a description and evaluation of an effective grass-roots, community-based intervention strategy involving menstrual education for rural adolescent girls in India. The effectiveness of the intervention in promoting behavior change was shown through both survey as well as focus group methods. Desired long run implications for interventions of this kind are improved reproductive outcomes, including maternal morbidity and mortality, clearly supportive of the MDGs.
"Maternal Healthcare and the Spread of AIDS" by Deuchert uses Demographic and Health Survey (DHS) data to argue that more attention needs to be paid to unsafe practices in the delivery of medical care, to prevent iatrogenic transmission of HIV. The epidemic is more, therefore, than just social and sexual behaviors. Deuchart's analysis shows a strong association between formal healthcare (tetanus toxoid injections during pregnancy) and HIV seropositivity. The HIV epidemic needs to be addressed from many fronts, and improved healthcare delivery is certainly one.
In summary, WHP is pleased to support the Council of Science Editors Global Theme Issue with these papers, and the editorial by Mike Landry and Sudha Raman explicating the Millennium Development Goals. WHP remains committed to its mission to provide a forum for researchers and policy makers worldwide to publish and disseminate health- and population-related research, and to encourage applied research and policy analysis from diverse international settings.
We hope that you also find these articles of interest and value, and will additionally consult other papers released online at www.worldhealthandpopulation.com. The editors and publishers of WHP are always interested in any comments or suggestions you might have on the articles or journal. Please feel free to write or e-mail us.
About the Author(s)
John E. Paul, PhD
Editor-in-Chief, World Health & Population
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