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East African Medical Journal

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Volume 80 No 1 January 2003
ABSTRACTS

COMPARISON OF VACCINATION STATUS OF CHILDREN BORN IN HEALTH UNITS AND THOSE BORN AT HOME

A. Odiit, Paediatrician and B. Amuge, Senior Nursing Officer and Health Visitor, Jinja Hospital,Uganda

Request for reprints to:  Dr. A. Odiit, Department of Paediatrics and Child Health, Mulago Hospital, P.O. Box 7072, Kampala, Uganda

ABSTRACT

Background: The Expanded Programme of Immunisation schedule starts at birth, yet a significant number of child births in Uganda occur at home, where there are no vaccines. A child born at home may therefore have less chances of being vaccinated than a child born in a health unit.

Objectives: To investigate vaccination status of the under-fives and to establish whether vaccination status of children born in health units is better than those born at home.

DesignCross-sectional descriptive.

Setting: Paediatrics out-patient clinic of Jinja Hospital, a regional referral health facility in Eastern Uganda.

Methods: Children under five years were enrolled consecutively as they arrived at the registration desk. The child health card and physical examination for BCG scar were used to establish the vaccination status of each child. A structured questionnaire was used for collecting relevant data.

Results: Of the 486 children sampled, 79 had been born at home, and 407 had been born in health units. Overall, 68% of the children were fully vaccinated for age. A child born in a health unit was significantly more likely to have a BCG scar (p = 0.0087), and to be upto date with their vaccination (p = 0.0173), compared to a child born at home. Vaccine drop-out rate was similarly high irrespective of whether the children were born at home or in health units.

Conclusion: Being born at home was found to be a risk factor for incomplete or non-vaccination. Continuation of vaccination was similarly poor in children born at home and those born in health units.

 

 

PRIMARY HEALTH CARE, SELECTIVE OR COMPREHENSIVE, WHICH WAY TO GO?

E.M. Obimbo, MBChB, MMed, Lecturer, Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya

ABSTRACT

Objective: To critically review the advantages and disadvantages of selective versus comprehensive Primary Health Care(PHC) approaches as a strategy towards improving health in the developing world.

Data sources: Review of literature on PHC.

Data selection: Relevant papers from western and developing world literature.

Data extraction: Search of Pub-med, WHO/UNICEF reports, and relevant publications on

PHC.

Data synthesis: Examination of principles behind PHC and practical experiences in PHC in the developing world.

ConclusionsSelective PHC programs have improved specific aspects of health, frequently at the expense of other health sectors, but fail to address an individual’s health in holistic manner, or the health infrastructure of countries. Selective PHC programs tend to focus only on a small subset of the community. Comprehensive PHC is expensive to implement, however addresses health of individuals more holistically, addresses both preventive and curative health care, and promotes health infrastructure development and community involvement, thereby providing more sustainable improvement of health in the whole community.

 

 

 

DAILY VERSUS WEEKLY IRON SUPPLEMENTATION AND PREVENTION OF IRON DEFICIENCY ANAEMIA IN LACTATING WOMEN

J. Haidar, MD, Ethiopian Health and Nutrition Research Institute, P.O. Box 5654, Addis Ababa, Ethiopia

A.M. Omwega, PhD

N.M. Muroki, PhD, Applied Human Nutrition Programme, Department of Food Technology and Nutrition, University of Nairobi, P.O. Box 442, Uthiru, Kenya

G. Ayana, MSc, Ethiopian Health and Nutrition Research Institute, P.O. Box,5654, Addis Ababa, Ethiopia

Request for reprints to:  Dr. A.M. Omwega, Applied Human Nutrition Programme, Department of Food Technology and Nutrition, University of Nairobi, P.O. Box 442, Uthiru, Nairobi, Kenya

ABSTRACT

Objective: To demonstrate the effectivene