Carl Kendall

The household production of health: Integrating social science perspectives on micro-level health determinants

Efforts to control disease and improve health in developing countries require increasing collaboration between social and medical scientists. This collaboration should extend from the early stages of technology development to the evaluation and improvement of population-wide interventions. This paper provides an integrating framework for social science research on health producing processes at the household level, drawing on recent work in economics, anthropology, and public health. Further development of theory and methods in this area would benefit from interdisciplinary research in categories as defined by social and behavioral science in addition to those related to specific diseases and intervention programs.

Effect of a community-based Aedes aegypti control programme on mosquito larval production sites in El Progreso, Honduras

This paper describes the results of a trial to assess the efficacy in reducing the density of larval production sites of utilizing community involvement in the planning and implementation of an Aedes aegypti control programme, in a dengue-endemic city in Honduras. In addition to a substantial increase in knowledge about dengue transmission and prevention, a relative reduction in Ae. aegypti larval infestation indices was found in those city neighbourhoods where community involvement was utilized compared with their untreated counterparts. Several methods of improving the impact of this type of programme are discussed.

Explaining Differences between Qualitative and Quantitative Data: A Study of Chemoprophylaxis during Pregnancy

Experts acknowledge that communication projects would benefit from the use of open-ended interviews, focus groups, surveys, trials of behaviors, observation, and other research techniques to identify community and individual knowledge, beliefs, preferences, actual behavior, as well as a host of sociodemographic and economic characteristics necessary for planning and implementation. Communication planners often rely exclu sively on survey research for program planning, claiming ease of administration and reliability of results. Reliance on this single research method often results in less appro priate interventions than could be developed with multiple research methods. This article reports the use of multiple methods to examine the cultural and behavioral factors which influence the use of antimalarial chemoprophylaxis during pregnancy in Malawi, Central Africa. This article will demonstrate how quantitative techniques such as cross sectional interviews and chemical tests as well as qualitative ethnographic information were used in the study; demonstrate how diverse results from multiple research techniques may be integrated; discuss general sources of bias in this research; and show how the use of multiple research methods may be incorporated in formative research for health com munication programs.

The implementation of a diarrheal disease control program in Honduras: Is it ‘selective primary health care’ or ‘integrated primary health care’?

International public health scientists have debated the distinction of selective and integrated primary health care since the development of new selective primary health care interventions such as the Expanded Programme on Immunizations and the Diarrhoeal Disease Control Programme of the World Health Organization were developed. This paper argues that the codification offered by the identification of two incompatible paradigms is not a productive one for describing the implementation of national-level primary health care programs. This paper will explore these concerns by reviewing case materials of the implementation of a diarrheal diseases control program in Honduras.

Fluids and powders: options for infant feeding.

This study involved collecting qualitative and quantitative data to investigate infant feeding practices in an urban low-income population of Central America, Tegucigalpa, Honduras. Ethnographic information, the subject of the article, was collected over a 9-month period in 1981-1982 in a longitudinal study of 75 families with infants. A subsequent census of more than 5000 households strengthened the results of the ethnographic study. Taxonomy of milk fed to infants was the most useful analysis for understanding infant feeding practices at the household level in the low-income culture of Tegucigalpa. This paper presents a taxonomy of milks fed to infants and explores infant feeding behavior in light of those beliefs. 2 prenatal visits were usually made to each mother. Each participating family was assigned to a fieldworker. Periodic visits were also made following the birth of the infant. The data derived from the 9-month study consist of detailed case histories; comments and explorations of hypotheses by the fieldworkers; infant feeding histories; texts of interviews with mothers and other family members; morbidity, mortality, and growth records; and extensive observational descriptions by the fieldworkers of mothers, infants, and their families. In urban Honduras, the majority of the women combine breastfeeding with feeding a breastmilk substitute to their infants. Over 95% of mothers initiate breastfeeding. 1/2 of all infants are completely weaned from the breast midway through their 1st year. Bottlefeeding is associated with infant morbidity, especially diarrhea. Breastfeeding is associated with reduced morbidity and improved growth.

Exploratory Ethnoentomology: Using ANTHROPAC to Design a Dengue Fever Control Program

Carl Kendall (Johns Hopkins) Elli Leontsini (Johns Hopkins) Enrique Gil (PROCCOD) Fernando Cruz (PROCCOD) Patricia Hudelson (Johns Hopkins) Pertti Pelto (Connecticut) This report presents initial results of data collection in a pilot dengue fever control program PROCCOD (Proyecto de Control Comunitario del Dengue) in El Progreso, a small city approximately 30 kilometers southeast of San Pedro Sula, Honduras.