Health promotions: issues and answers

In recent years, increased attention has been given to the development of health promotion programmes in a number of countries worldwide. Although health promotion itself is not new, a number of issues have been emerged as the underlying concepts are articulated and put into practice. These relate to its relevance and ownership and to practical issues such as measurement of outcomes. This article provides a brief discussion on some of these issues and makes reference to Caribbean framework for implementing health promotion (AU)

Pre-hospital Emergency Medical Services, Phase I: Role of the Department of Community Health and Psychiatry

The Department of Community Health and Psychiatry was contracted by the Ministry of Health to assist with the implementation of a pilot programme in the Western Health Region to train fire fighters as basic level Emergency Medical Technicians (EMTs), and was responsible for its design, implementation and monitoring for first 18 months. The course was covered in 440 hours over a 10 week period, and included training in emergency medical response, driving an emergency medical vehicle, emergency medical despatching and inventory control. Of 76 fire fighters selected for training, 62 graduated, receiving Certificate of Merit from the Ministry of Health, Jamaica and were deployed into service on 17th April 1996. During the period 17 April to 31 December, 1996, the newly trained EMT's responded to 1,299 calls. Medical and surgical cases represented approximately 55 percent of all calls, followed by trauma (19 percent), motor vehicle accident (9 percent) and obstetric emergencies (8 percent). Between 15 percent and 20 percent of calls in Montego Bay and Negril involved tourists. This first group of EMT's has performed well and was well received by the communities and the persons who used the service.(AU)

Development of a questionnaire for assessing the school environment

This article describes the development of a school environment questionnaire to assess student's perception of their school environment. The dimensions and internal consistency reliability were examined ulitlzing various statistical methods - factor analysis and alpha coefficient. The sample consisted of 705 students from two high schools with ages ranging from ten to nineteen years. Results showed that the students perceived their school as having various aspects, rather than a global point of view. Factor analysis identified seven dimensions in the school environment: external characteristics of the environment, aesthetic and functional elements of the classroom, students' bathroom, the canteen and staffroom, the aesthetic and functional elements of the school as a whole and sanitation. Overall the internal reliability of the factors was high. Implications for school health programs are addressed. (au)

Teacher's perception of those factors which promote and those which act as deterrents to good health

As part of a health promotion school intervention project, the teachers of a coeducational high school were surveyed by questionnaire, to determine their perception of the factors which contribute to good health and those which act as deterents. Of 50 teachers asked to complete the questionnaire, approximately 80 percent responded. The factors they perceived as contributing to good health were: proper eating habits, exercise, good mental, physical and spiritual health, healthy lifestyles, clean surroundings, good hygiene, awareness of good health and education on health principles. Those contributing to ill health which needed addressing were the environment, substance abuse, sexual practices and personal hygiene, exercise, stress, life skills, self esteem, and interpersonal relationships. This pilot survey will be refined to extend to other schools, and the results coupled with results from questionaires completed by students, will form the basis for setting priorities for intervention activities. (AU)

Continuing education and standards of practice for family physicians: proceedings of workshop held January 26th 1991, The Courtleigh Hotel, Kingston, Jamaica, W. I

This report represents the cumulative effort of the chairpersons, participants and the secretariat of seven workshops which were held on January 26, 1991 at the Courtleigh Hotel, Kingston. The purpose of the activities was to discuss Continuing Education and Standards of Practice for Family Physicians in the region and to provide guidelines for implementation of the ensuing recommendations.

Continuing education and standards of practice for family physicians: proceedings of workshop held January 26th 1991, The Courtleigh Hotel, Kingston, Jamaica, W.I.

This report represents the cumulative effort of the chairpersons, participants and the secretariat of seven workshops which were held on January 26, 1991 at the Courtleigh Hotel, Kingston. The purpose of the activities was to discuss Continuing Education and Standards of Practice for Family Physicians in the region and to provide guidelines for implementation of the ensuing recommendations. (AU)

Breast feeding promotion in an urban and a rural Jamaican hospital

Breast feeding promotion has been a national priority in Jamaica since the mid-1970s. Despite this effort, breast feeding rates have continued to decline there, especially in urban areas. Studies of the role of health professionals in promoting breast feeding have shown that specific practices encourage breast feeding, while others discourage it. In the context of declining breast feeding in a nation committed to promoting it, the goal of this study was to explore the relationship between specific health professional practices, mothers' breast feeding, and mothers' knowledge of breast feeding in rural and urban Jamaica. To accomplish this goal, a structured interview was administered to 113 mothers of infants age 0-6 months at one urban (n=62) and one rural (n=51) hospital, regarding (1) physician and nurse practices known to affect breast feeding, (2) mothers' own breast feeding practices, and (3) mothers knowledge of breast feeding issues. Physician and nurse visits were also directly observed to confirm responses given to the questionnaire and to assess the resources devoted to teaching mothers about breast feeding. While extensive lectures, posters and pamphlets promoting breast feeding were provided for mothers at the urban hospital, far fewer educational resources were available for mothers at the rural hospital. Overall, however, health professional practices discouraging breast feeding were observed more frequently at the urban hospital than at the rural hospital, whereas practices promoting breast feeding were more common at the rural hospital. At the rural hospital, mothers' breast feeding practices more closely approximated recommendations than at the urban hospital. Moreover, there was no difference between urban and rural mothers' knowledge about breast feeding despite the input of far greater educational resources to mothers at the urban hospital. This study suggests that merely educating mothers about feeding is insufficient. Efforts to promote breast feeding must emphasize specific health professional practices that support early initiation of breast feeding. The health policy implications of these findings are discussed. (AU)

Morbidity pattern of emergencies at the Bustamante Hospital for Children (January-December, 1986)

A one-year retrospective study of paediatric emergencies seen at the Bustamante Hospital for Children for the period January 16 to December 31, 1986 is presented. Thirty-four per cent (3,918) of a total of 11,495 patients seen in the Casualty Department for 100 randomly selected days were assessed as emergencies. The most frequently seen emergencies were gastroenteritis (42.55 percent of total emergencies) followed by bronchial asthma (23.0 percent) and shortness of breath (16.51 percent). The rigid classification of emergencies by disease category needs to be reappraised (AU)