Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

Health Care for the disadvantaged: some preliminary observations of health centres in Trinidad and Tobago

This study seeks to identify background characteristics of the people who utilize health care services in Trinidad and Tobago and to investigate their perceptions of the services offered. Data were collected through a survey of health care users distributed throughout Trinidad and Tobago. Multi-stage sampling was used to select 1500 health care users and structured interviews were conducted on regular clinic days by trained personnel. Results indicate that there are fairly high levels of patient satisfaction with health care centres in Trinidad and Tobago and that the more disadvantaged groups (the elderly, women and the unemployed) utilize these services more frequently. Results also show variations with respect to pay, services that need improving and doctor's willingness to listen to problems. (AU)

Turnaround time in the surgical pathology laboratory

One measure of the efficiency of a surgical pathology service is the rapidity of reporting the diagnosis to clinicians. The turnaround time (TAT) has been used for this purpose. This study showed that the TAT for 66 percent of specimens submitted to the surgical pathology laboratory in the University Hospital of the West Indies was within 3 days and for 89 percent within 6 days. The TAT within 7 days was considered acceptable, but it was shown that it was more than 7 days for 9 percent, of the specimens submitted. The importance of this information is discussed and recommendations made for identifying more accurately the source of delays in those cases in which the TAT was considered to be unusually prolonged.(AU)

Patient perception and satisfaction with health care professionals at primary care facilities in Trinidad and Tobago

This paper endeavours to identify the background characteristics of health centre users in Trinidad and Tobago and their perceptions of the efficiency of the services provided. Multistage sampling was employed to select 1451 users. Data were obtained during structured interviews on regular clinic days. Of the people using the health centres, 80.4 percent were unemployed and 75.9 percent were women. People aged over 60 accounted for 25.4 percent of the sample. Users included a disproportionately high number of persons from the lower socioeconomic categories. The proportions of persons of different ethnic and religious groups closely reflected those in the country's general population. Approximately 74 percent of the interviewees were satisfied with the performance of the doctors in the health centres. For nurses the satisfaction rating was about 10 percent higher. The greatest needs for improvement were perceived to be in pharmacists' and doctors' services, with particular reference to waiting times.(Au)