Disparities in rural-vs-urban achievement of millennium development goals in Cambodia: implications for current and future child health.

BACKGROUND: Cambodia has made significant economic, political, and health advancements with the implementation of the millennium development goals (MDG). Important gaps in child health still exist, however, and accurate assessments of lingering disparities within the country will be essential for meeting the Sustainable Development Goals by 2030. AIM: This investigation hypothesised that child-health improvements in rural areas of Cambodia continue to lag behind urban areas. The study objective was to identify specific disparities in rural achievement of MDG within Cambodia to direct future work in child health. METHODS: Surveys were conducted in 230 rural households in four villages in Kampot and Kampong Speu provinces to assess risk factors contributing to lack of village-level achievement of MDG. National urban and rural data were used for comparison. RESULTS: An under-5 death in the preceding year was reported by 11.5% (n = 26) of the households surveyed. Under-use of common public health interventions (vaccinations, clean drinking water, oral rehydration therapy, iodised salt, bed nets, antenatal care, and improved sanitation facilities) was observed in all villages. Under-use of the interventions was more common in rural than urban areas. CONCLUSION: Achievement of child-health-related MDG lags in rural areas of Cambodia. Child health risk factors varied widely among villages. Village-specific risk factors for which immediate action can be taken are a priority, particularly vaccination in Angkcheay and Takoa and clean drinking water in Pos Pong. Elimination of disparities in rural child health will ultimately require significant resource allocation in rural areas, e.g. improved sanitation facilities, piped water supply and sustained public health initiatives.

The role of standards and training in preparing for accreditation.

Laboratory test results are the cornerstone for patient diagnosis and treatment, and the principles of high-quality laboratory testing are the same anywhere in the world. It is one area of health care that can and should be standardized. Resource-limited countries' laboratories lack equipment, proper funding, adequate training for laboratory workers, and systematic management of work, making it difficult to deliver accurate and reliable results. Quality management tools are being used to improve practices, with accreditation being a means to demonstrate that standards are being met. The World Health Organization (WHO), the US Centers for Disease Control and Prevention, and the Clinical and Laboratory Standards Institute have assumed responsibility for leading a harmonized approach to the provision of education and training in laboratories by publishing a training tool kit. The WHO Regional Office for Africa is leading a new stepwise approach to accreditation.

Student perceptions of the clinical laboratory science profession.

OBJECTIVE: The purpose of this paper is to describe the attitudes and perceptions among college biology and CLS/CLT students. These students were on selected college campuses at Texas universities in Houston, Dallas and the Austin/San Antonio areas for the Spring 2007 semester. Specifically, students were questioned on factors that influence their choice of field of study, career expectations, legislative measures which might be used to attract individuals to the career, and factors that will be required to keep them in the field of practice. DESIGN: This study was part of a larger qualitative study which included exploratory discovery and inductive logic regarding the attitudes of four focus groups in Texas. SETTING: Focus groups took place on college campuses or in hotel conference rooms. PARTICIPANTS: (1) junior/senior-level college biology students and (2) junior/senior-level students currently enrolled in CLS/CLT programs. INTERVENTIONS: Focus group discussions using a standard set of questions; group sessions lasted about 45 minutes. MAIN OUTCOME MEASURE: This study was a qualitative study which included exploratory discovery and inductive logic regarding the attitudes of two groups in Texas. RESULTS: College biology and CLS/CLT students find the clinical laboratory science profession to be interesting and exciting as a career prospect, however, many do not see themselves remaining in the profession and perceive it does not have good prospects for career advancement. The majority of students must work to support themselves through their college education and would welcome additional grants, scholarships and loan forgiveness programs as incentives to study the clinical laboratory sciences. Students believe that additional recruitment on high school and college campuses is needed to increase the visibility of the field as career choice. CONCLUSION: The majority of students who are entering the clinical laboratory science profession do not see the profession as their final career choice, but rather a stepping stone to another career field in healthcare or a related field. The perception that the profession lacks a career ladder is a critical detriment to the retention of CLS/CLT professionals. The clinical laboratory science profession continues to suffer from a lack of knowledge about the field by the general public, college advisors, and even healthcare workers. State and national programs involving grants/scholarships or loan forgiveness programs offered by healthcare institutions would be beneficial in attracting students to study the clinical laboratory sciences.