Why do some women bypass their family physician in seeking preventive care?: a qualitative study [abstract]

The Health Watch clinic at Women's College Hospital, Toronto, provides screening and preventive services primarily to women in Ontario. These services can be seen as a duplication of those that can be provided by family physicians. Nevertheless, some Ontario women continue to bypass their family physicians and attend this clinic. This study was done to understand the decision-making processes women go through in deciding to bypass their family physician when seeking preventive health services and to understand which features of this model of preventive care are so attractive. Seventeen women attending the Health Watch Clinic agreed to participate. In-depth interviews were carried out until saturation was achieved. The interviews were taped and later transcribed. The data were analyzed using qualitative methods, specifically, grounded in theory. Emergent themes were extracted while listening to tapes and reading transcripts. Themes were discussed between researchers and an agreement was arrived at. These themes were relayed back to participants to confirm interpretation. The emerging themes suggest that women bypass the family physician for several reasons, including: "Women negative" experiences, the inherent qualities of the woman, such as her locus of control, normative influences, and perceived positive aspects of the Health Watch Clinic and the Women's College Hospital. The findings suggest that women who bypass their family doctor have generally had a negative experience with the traditional healthcare system. The women in this study were highly educated with high internal motivation and tended to have extensive family and friend support and advice regarding health matters. (AU)

New protocol of early preventative screening of children in coorporation with the island health services [abstract]

The protocol "Early Preventive Visual Screening of Children" has been developed in mutual Cooperation with both the Islands Ophthalmologic Society and the Department of Youth Preventitive Medicine of the Island Health Service. The aim is to periodically screen for function of the visual system in children starting at a very young age and going up to age 15 years. This means that at an early stage, dysfunctional problems can be detected and appropriately dealth with. This protocol has two parts. The first one is about the visual examination and the second part has to do with the visual acuity measurement in children. (AU)

Primary health care related knowledge attitudes and perceptions of academic staff and medical graduates of the Faculty of Medical Sciences, Mona, University of the West Indies

Primary health care (PHC) is the designated mode to achieve Health For All (HFA) by the Year 2000 (HFA 2000). To this end many organisations and institutions have implemented training programmes to ensure the dissemination of information relating to this concept. In April 1994, a cross-sectional study was conducted on a sample of 81 members of the academic staff of the Faculty of Medical Sciences, Mona, and 81 medical graduates for the years 1982-1992. A self-administered questionnaire was used to ascertain information on knowledge, attitudes and perception. The study revealed that knowledge about HFA and PHC was widely disseminated among both groups although specific knowledge components were far from clear. The graduates scored always marginally better than faculty for knowledge (p < 0.0005). Both groups reported favourable attitudes towards HFA and PHC. However a considerable proportion reported that "HFA is a Utopian ideal". The graduates showed higher attitudinal scores than the faculty (p<0.0004). Seventy seven percent of the academic staff and 85 percent of the graduates perceived PHC to be of practical significance to their job while 43 percent and 58 percent of the academic staff and graduates respectively considered the faculty training programme to be inadequate. These findings suggest that the Faculty of Medical Sciences should have continuing medical education activities giving greater importance to primary health care. Further, periodic and summative evaluation of all programmes be conducted. (AU)

Coverage survey, an evaluation of the immunization programme for infants - abstract

The objective of this study was to obtain information on the coverage rate for DPT, poliomyelitis and MMR/measles and rubella among children in Curacao. A cluster sampling technique was used to select 211 children, aged 15 to 26 months, whose immunization status was evaluated. Data were obtained from the immunization card and by interviewing the parent. The coverage rate ranged from 99.1 percent (first DPT) to 70.6 percent(MMR); 67.8 percent of children were fully immunized. Two children (0.9 percent were not immunized at all. Less than 10 percent of all immunization doses was administered outside the Well Baby Clinics. Some of the recorded doses were given too early (invalid)according to the WHO criteria. Accurate registration was recommended as a possible way to decrease the number of invalid doses. It was found that many of the 3 doses of poliomyelitis vaccine were administered too late and it is recommended that the 3rd oral polio dose should be given earlier. Reasons why children were not fully immunized could be divided into: obstacles to participation in the programme (55.9 percent), lack of motivation (10.3 percent) and lack of information (33.8 percent). Illness of the child was the main obstacle (AU)

The Caribbean Epidemiology Centre (CAREC)

The Caribbean Epidemiology Centre began operating on 1 January 1975 under the adminstrative management of the Pan American Health Organization (PAHO) at the request of the Caribbean Health Ministers' Conference held in the Bahamas in 1974. This presentation outlines the events leading to formation of the Centre and describes its structure, objectives, and development from January 1975 through 1978 (AU)

An analysis of health problems of Commonwealth Caribbean countries and the priorities

In summary, then, new curricula and new methods of training are needed and these should be designed for our special needs. There must be experimentation in the provision and organization of health services and the delivery of health care. There must be a recognition of the needs of the society and the changes necessary to meet them. In our Caribbean communities, we are now at the critical stage where our health manpower needs cannot possibly be met by using the present methods. It is also important that more persons in health receive training in managerial skills (AU)