The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.
Matched MeSH terms: Allied Health Personnel/statistics & numerical data*; Community Health Workers/statistics & numerical data*
The Cardiothoracic Department, General Hospital, Kuala Lumpur which was set up in April 1982, deals with a wide range of cardiac disease, general thoracic and also vascular cases. A total of 2,450 operations were performed from April 1982 to February 1987, and 79.3% of these were for cardiac cases (open and closed heart). This paper reports a review of the 1,110 consecutive open heart operations performed by the Department during the stated period.
A study was conducted to determine the prevalence of locomotor disability in a Malay Community in Tanjung Karang, Kuala Selangor in 1984. The causes of these disabilities, the mobility and occupational handicaps they caused and the types of treatment received were determined. Fifty percent of the households in this area were selected by stratified random sampling and all persons above seven years of age were included in the sample. The prevalence of locomotor disability was 3.9%. The prevalence among males was 5.2% and among females 2.6%. The prevalence increased with age, being as low as 0.6% in the 7-14 year age group and as high as 20.5% in the above 55 year age group. The disabilities resulted mainly from trauma (49%) and musculoskeletal and neurological problems (46.9%). Ninety percent (44 cases) had difficulty only in performance of daily activity and 20 cases (40.8%) had no mobility handicap whatsoever. Forty two (85.7%) of the 49 cases had received treatment.
This study compares levels of geohelminth infection in children living in rural estates and urban slum areas of Malaysia. The statistical characteristics of geohelminth infection in 1499 children from birth up to 15 years of age, living in rural estates, were analysed according to age, sex and ethnic origin and compared with the same statistics for 1574 slum-dwelling children of similar age groups and ethnic origins. The prevalence and intensity of ascariasis and trichuriasis were significantly higher among children from the urban slums. Slum-dwelling ethnic Indians and Malays had higher levels of infection with Ascaris lumbricoides and Trichuris trichiura than their rural counterparts, but the infection status of the ethnic Chinese in the 2 areas was similar. Hookworm infection was similar in both areas, indicating that hookworm infection is neither necessarily nor solely a rural disease. These results suggest that urban slum children are at greater risk of ascariasis and trichuriasis than their rural counterparts.
Using logit techniques and data from surveys of the elderly conducted in 1984 under the auspices of the World Health Organization, this article investigates socioeconomic, cultural, and demographic determinants of living arrangements of the elderly. Having a spouse or children with whom to live has important effects on living arrangements. The results provide only weak support, however, for hypotheses based on modernization theory and point to the need for detailed data on transitions in living arrangements and for information about the younger generation as well as the older generation, both of which are involved in deciding who lives with whom.
Although the patterns of dental disease is gradually changing, caries and periodontal disease still account for the most important reason for extractions in most countries. However their relative contributions towards overall tooth mortality figures varies. The aim of this study is to investigate the types of teeth usually associated with extractions due to caries or periodontal disease and its relation to the age at which the tooth was lost. The highest proportion of extractions due to caries occurred between 21 to 30 years of age while that for periodontal disease occurred between 41 to 50 years. For caries, the greatest proportion of extractions involved the posterior teeth. The most frequently extracted teeth due to caries are the molars, in particular the first permanent molar. However, for periodontal disease a slightly greater proportion of anterior teeth were lost than the posteriors. This trend is more marked in the lower jaw than the upper. Overall, extractions related to caries tend to increase posteriorly, while that for periodontal disease tend to increase anteriorly.
The reasons underlying the need for extraction of 2765 permanent teeth carried out over a 6 month period in the Out-patient Clinic in the Dental Faculty, University of Malaya, was investigated. The present study showed that dental caries (67.4%) is the leading cause for extraction followed by periodontal disease (19.6%). Caries accounted for the highest proportion of extractions up to the age of 50 whereas periodontal disease becomes the major factor beyond this age. The highest frequency of extractions carried out was between the ages of 21-30.
Matched MeSH terms: Tooth Extraction/statistics & numerical data