Wiley Henry Mosley

Johns Hopkins University | JHU · Department of Population, Family and Reproductive Health

The article by Monique and Jeffery Wubbenhorst asks the question—Should Evangelical Christian Organizations Support International Family Planning?1 The article’s response to this question shows a lack of understanding of the fundamentals of population dynamics in the modern world as well as of the critical role contraceptives play in preventing uni...

The strategic leadership principles used in this presentation draws on the vast literature in the field of leadership and will incorporate the five leadership disciplines introduced by Peter Senge in his seminal book, The Fifth Discipline. The Art and Practice of the Learning Organization (1990). These disciplines, which are adapted to developing c...

This presentation will explore key components of global public health leadership framed in the concept of a future that everyone shares. Participants will be provided with examples and complementary activities to help hone their leadership skills to ensure they work effectively in an international health context. Of note, the 21st century will be t...

We sought to determine the pattern of the concurrent sexual partnerships among Chinese men and its correlates with individual, partnership and community factors. Using data from the Chinese Health and Family Life Survey, we examined the prevalence and distribution of sexual concurrency of 1689 men. A two-level logistic regression was employed to as...

We have introduced a new way of thinking about a country’s “health system” that has relevance for leaders and managers concerned with improving the effectiveness and sustainability of health interventions. Basically, we propose that a nation’s health production system should be looked on like its agricultural production system – just as farming hou...

Maternal mortality is a serious public health concern in Bangladesh. However, most deaths could be prevented through proper and timely care seeking and adequate management. Unfortunately, fewer than half of pregnant women in Bangladesh seek antenatal care, and only one in eight receive delivery care from medically trained providers. The specific ob...

The advantage of condom use for preventing HIV has been limited by people's selective use with different partners: more use with casual partners than with primary partners. The different rates of condom use with different partners imply the different influencing factors associated with partner types. The present study estimates the partner-specific...

Proposes a new analytical framework for the study of child survival in developing countries, incorporating both social and biological variables and employing methods of social and medical sciences. The framework includes the use of a single-valued measure of morbidity and mortality. Five intermediate variables are identified through which all socio...

This study examined the relationship between the use of maternal-child health (MCH) care and the use of contraceptives. The high correlation between the two may be due to the independent effect of one on the other or to an association of both with the same or similar background factors. We used structural equation models to examine the relationship...

As a result of the demographic and epidemiological transitions now occurring rapidly in many developed countries, a dramatic shift in the age structures of populations and the burden of disease towards the middle-aged and elderly is expected to take place over the next several decades. In the 1990s, however, there remains great diversity across cou...

The child survival strategy in developing countries has been driven largely by a selective disease control approach, which focuses on a few specific and inexpensive technical interventions directed toward conditions such as acute dehydrating diarrhoea and the immunizable diseases. Conceptually, this approach of designing health programmes in poorer...

Health systems in developing countries are facing major challenges in the 1990s and beyond because of a growing epidemiological diversity as a consequence of rapid economic development and declining fertility. The infectious and parasitic diseases of childhood must remain a priority at the same time the chronic diseases among adults are emerging as...

In this review we assess the extent to which programmatic and intellectual emphasis on CCD problems should remain as an appropriate focus in the decade of the 1990s and beyond. To summarize our conclusions we believe that more attention will need to be paid to the problems of postepidemiologic transition environments; that within the pretransition...

The dictionary defines technological advances as the application of scientific knowledge, methods or research to the industrial arts or some productive process to increase productivity and/or eliminate manual operations. This paper examines some of the advances in scientific knowledge and technology to assess how they interact with the productive e...

This document describes advances in a conceptual framework under development since 1984 for research on child survival in developing countries. The framework links variables explaining biologically determined disease processes to social determinants in the family and community. The major addition is the extension of previous models of proximate det...

Comprehensive primary health care and selective primary health care are often unnecessarily considered mutually exclusive positions. It is frequently assumed that as they are defined the frameworks of each are different and that acceptance of 1 approach precludes the acceptance of the other. A problem-oriented approach is suggested as a middle way....

A census was done in Saradidi, Kenya from 1980 to 1982 as part of a community-based health development programme. The population was 42,755 (excluding 39 persons of unknown age or sex); 17.1% were less than five years old, 46.9% were below age 15, 4.7% were age 65 years or older and 19.7% were women in the reproductive years (age 15 to 44 years). T...

Mortality and fertility rates were measured from 1981 to 1983 by prospective registration of vital events as part of a community-based malaria control and health development programme in Saradidi, Kenya. There was no obvious effect of providing chloroquine phosphate for treatment of malaria in each village on mortality or fertility rates. Crude dea...

Considers the conceptual framework, and approaches using bio-medical and social science perspectives. Reviews major pieces of empirical work and introduces related papers in the collection. Considers data collection strategies and the role of mathematical modelling in research and policy making. -A.L.Creese

Khan MU [International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR, B), Dacca—12], Mosley WH, Chakraborty J, Majid Sarder A and Khan MR. The relationship of cholera to water source and use in rural Bangladesh. International Journal of Epidemiology 1981, 10: 23–25. The cholera experience of a sample of families in a rural area of Bangl...

The results of a survey of 150 villages in rural Bangladesh indicate that a substantial fraction of couples desire to control childbearing and will effectively initiate contraceptive practice if information and supplies are provided. -P.Compton

There is a substantial unmet need for contraceptives in rural areas of Bangladesh which is not being adequately serviced by the simple household delivery of contraceptive supplies. As a consequence a new Family Planning-Health Services Project has been instituted better to meet the needs of individual women. -P.Compton

A modeling procedure was used to evaluate strategies of family planning acceptance in the Bangladesh context. Several different recommendations can be made as to when couples ought to begin using contraception: 1) fixed date strategies suggest that women begin use exactly a certain number of months (designated T) after birth; 2) the postamenorrheic...

Cholera has a distinctive epidemiological pattern. Epidemics, even in endemic areas, are sharply localized in time and place. The 'place' specificity points to the essential requirement for water to facilitate disease transmission. The age, sex, occupational risks of disease are primarily related to exposure to contaminated water. This exposure may...

The average length of postpartum amenorrhea reported by breast-feeding women in rural Bangladesh in 1975 was 18 to 20 months. Its duration was found to be only slightly related to maternal nutritional status. There was no evidence of a threshold of weight for height necessary for the resumption of menses postpartum. Factors related to the duration...

A cross-sectional survey of 2048 breastfeeding women in rural Bangladesh was conducted in 1975 to explore factors affecting the duration of post-partum amenorrhoea. Information on menstrual status, infant supplementation, socio-economic status and anthropometric measurements was collected for lactating women with infants 13–21 months of age. The me...

The papers in this section review both historical records as well as recent studies which highlight how malnutrition, specifically maternal malnutrition, may depress reproductive performance in human populations. In these reports attention is focused particularly on nutrition and its effect on the reproductive life span, on fecundibility, and on su...

Rapid population growth and limited world food supplies are universally recognized as two of the major global problems confronting mankind in this generation. The interdependence of population growth and food has been recognized since Malthus; however, the focus of interest has largely centered on nutrition and mortality. Only recently has it been...

This book is the product of the Conference on Nutrition and Human Reproduction, supported and organized by the National Insti­ tutes of Child Health and Human Development, and held at the National Institutes of Health, Bethesda, Maryland, in February 1977. The genesis of this Conference came from the work of the Subcommittee on Nutrition and Fertil...

Norethisterone Enanthate (NE) was used in 151 women as injectable contraceptive. Pregnancy due to method failure was 2% whereas the overall pregnancy was 4%. The results have been discussed.

A prospective controlled study on the maternity service of the American University Medical Center, Beirut, Lebanon, tested the effect of family planning education during the postpartum lying-in period on recruiting contraceptive acceptors. The study further determined how women with different socio-demographic backgrounds, life styles, and levels o...

One of the major goals of health programmes in the developing world is to improve maternal and child health. Two important steps towards achieving this goal are the promotion of birth spacing and the promotion of breast-feeding. Since birth spacing requires some type of fertility control measures, modern contraceptive programmes are becoming an int...

This article presents a new randomizing device to obtain discrete quantitative as well as qualitative data on sensitive problems. The total number of balls in the randomizing device and the ratio of the different color balls which represent different sensitive characteristics are shown to affect the efficiency of estimates.

In the two studies reported in this paper, the maternal mortality rates for a rural community of Bangladesh without access to modern health services were found to be 7.7 and 5.7 deaths per thousand live births. If they are representative of Bangladesh as a whole, they would imply that annually over 20,000 adult female deaths in this nation are rela...

PIP The August 1974 World Population Conference in Bucharest is unique as the first political conference on population ever held. It is also the first time that the United Nations has made population the sole subject of a major conference. The American Public Health Association, which recognized in 1959 the moral and ethical issues involved in the...

Abstract A group of 209 married, fecund women in rural Bangladesh were studied prospectively for 24 months from 1969 to 1971 to define some of the biological and sociological factors relating to fertility performance. These women were selected from a larger study population of 112,000 that had been followed with a daily house-to-house vital registr...

The effect of treatment of purified cholera enterotoxin with acid at pH 2.0 for 1 h followed by neutralization of the acid on the biological activity of the toxin has been studied. It was found that the material loses 85 to 96% of its skin permeability activity and this loss is neither reversed nor increased after 28 days of storage at 5 to 10 C. O...

742 family contacts of 149 cholera patients with bacteriologically confirmed Vibrio cholerœ Inaba infection were given either placebo (vaccine diluent) or monovalent Inaba vaccine of proven efficacy within 12 hours of hospital admission of the index case. Rectal swabs and histories of diarrhœa obtained daily for 10 consecutive days revealed no appr...

Analysis of the efficacy of cholera vaccines, the public-health structure of Bangladesh, and the epidemiology of cholera in rural Bengal indicates that mass vaccination programmes are an ineffective public-health measure. Under field conditions, vaccinating 5000 individual village contacts of active cases requires a vaccinator to work full-time for...

The levels of serum antibodies to cholera toxin can be measured by any of three test systems. Each of these assays (isolated fat cell, rabbit skin, and ileal loop) give similar values although there are differences in sensitivity among the systems. The variety of antisera and toxins tested makes it very likely that a single antigenantibody reaction...

PIP The methodologies used in policy formation, program planning and implementation in the field of population are limited. It is, therefore, difficult to critically analyze the issues in population policy. The inability to develop adequate methodologies is probably due to the inability to rationally define the problem. Nevertheless, until nations...

Demographic methods provide an invaluable foundation for population program planning by giving quantitative expression to present and future characteristics of a population. It must be recognized that, while the formulas may be precise, the validity of the outputs are constrained by the quality of input data available and the assumptions required....

A controlled cholera vaccine field trial was carried out to test the efficacy of monovalent whole-cell Inaba and Ogawa cholera vaccines and a purified Inaba antigen. This study was designed particularly to study the level of protection produced by these vaccines against homologous and heterologous serotypes and to correlate the results with mouse p...

Woodward, W. E. and W. H. Mosley (Johns Hopkins Univ. School of Hygiene & Public Health, Baltimore, Md. 21205). The spectrum of cholera in rural Bangladesh. II. Comparison of El Tor Ogawa and classical Inaba infection. Am J Epidemiol 96: 342–351, 1972. Study of epidemics of classical Inaba and El Tor Ogawa cholera, occurring in successive years in...

To determine levels of fecundity--the biological capacity for reproduction-- in various population segments and the effect of the fecundity levels on fertility rates 30155 ever-married women in the Matlab thana area of East Pakistan were interviewed on fecundity in early 1968 as part of a cholera eradication program. Fecundity was defined as some c...

Two medical relief assessments were carried out in the southern coastal region of East Bengal affected by the cyclone and tidal bore of November, 1970. The first, a rapid 18-site survey, documented the adequacy of existing water supplies and absence of significant post-cyclone morbidity or exceptional levels of epidemic diseases. The second, wider...

Stools and jejunal aspirates from patients with acute cholera were sterilized by filtration and stored at −40 C to −50 C. These filtrates were assayed for potency in the skin of the back of adult rabbits (measured by blueing doses and limit of blueing units) and for fluid-producing activity in the ligated intestinal loops. Two toxins prepared in vi...

Mosley, W. H. (Dept. of Population Dynamics, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205, U.S.A.), Bart, K. J., and Sommer, A. An epidemiological assessment of cholera control programs in rural East Pakistan. Int. J. Epid. 1972,1:5–11. Endemic cholera in rural East Pakistan occurs in annual epidemic wave...

A controlled cholera vaccine field trial was carried out in rural East Pakistan to determine the efficacy of a cholera vaccine of average antigenic potency when used in a continuing programme with annual reimmunizations. A cohort of 40 000 children aged 0-14 years was equally divided into a control group and 3 vaccine groups. Inoculations of vaccin...

The relative effectiveness of daily rectal-swab cultures and cultures of purged stools in detecting inapparent infections of Vibrio cholerae were compared in family contacts of cholera patients. In one study of 187 contacts, a combination of purging by various methods plus 5 daily swabs detected 50 infections. Only 27 (54%) were detected by the pur...

The potency of cholera vaccines as determined in the active mouse protection test was compared with their antigenicity when inoculated into human infants. There was general agreement in the two assay systems for bivalent vaccines, however there were some striking discrepancies with monovalent vaccines and purified antigens. A comparison of these tw...

Vibriocidal and agglutinating antibodies in sera from acute cholera cases, normal residents of endemic and non-endemic cholera areas and maternal and cord blood were characterized by 2-mercaptoethanol (2-ME) sensitivity and density gradient fractionation. In acute cholera there was a rapid and parallel rise in whole serum and 2-ME-resistant vibrioc...

A total of 247 family contacts of patients with El Tor Ogawa Vibrio cholerae and 73 family contacts of patients with classical Inaba V. cholera were studied during a simultaneous epidemic of both biotypes in Chittagong, East Pakistan, in 1968-1969. There was a distinctly different pattern of infection in family contacts. The infectiontocase ratio i...

A clear difference has been observed between the classical Inaba V. cholerae and the El Tor Ogawa V. cholerae in relation to the ability to isolate the organism from the environment.An early attempt to utilize nightsoil sampling as a tool to measure the extent of infection in the community during an epidemic of classical Inaba cholera in Dacca, Eas...