Whilst until the late 1980s most migration issues developed in a parallel manner but with national specifics, important differences showed up during the 1990s and at the beginning of this decade. Since the middle of the 1990s, there has been an obvious change in policy towards migrants and foreigners in the Netherlands, and those changes have been more or less “exported” to our neighbouring countries and even to the level of the EU. Integration into society with the maintenance of the immigrant’s own culture has been replaced by integration into the Dutch society after passing an integration examination. The focus of this article is to investigate those changes and to compare the implementation of those policies in the Netherlands/Limburg and Germany/NRW, where the official understanding of not being an immigration country was dominant until the end of the 1990s, and where integration has only recently become an important political issue. Both countries are now facing similar challenges for better integration into the society, especially into the educational system. Firstly, the autors describe migration definitions, types, the numbers of migrants and the backgrounds of migrant policies in Germany and the Netherlands up until the middle of the 1990s. Secondly they discuss the integration policies thereafter: the pathway to a new policy and the Action Plan Integration in Germany, and the central ideas of the Civic Integration of Newcomers Act (WIN) in the Netherlands. Integration policy in the Netherlands is highly centralised with little differentiation on the local governmental level when compared to South Limburg. Thirdly, the autors investigate the cross-border cooperation between professional organisations and educational institutions in the Euregio Meuse-Rhine, and the involvement of social work institutions and social workers in their process of integration into the local society and the exchange of each others’ experiences (the ECSW and RECES projects).
BACKGROUND: Primary Health Care (PHC) is well suited for management of low back pain (LBP). Prevalence of (chronic) LBP is suspected to be high among visitors of the South African primary care centers, but currently no information exists on prevalence or guideline adherence.OBJECTIVES: To establish if treatment received for LBP in public PHC in the Cape Town area compares with international evidence based guidelines.METHODS: Cluster randomization determined the 8 community health centres where the study took place. A measurement tool was developed and validated for this population. Descriptive analysis and logistic regression analytical techniques were applied.RESULTS: 489 participants (mean age: 44.8) were included in this study. Lifetime prevalence was 73.2% and 26.3% suffered from chronic low back pain (CLBP) . Pain medication was the only form of treatment received by 90% of the sample. Interventions received seemed to be unrelated to type of LBP (acute, sub acute and chronic). Referral to physiotherapy, education and advice to stay active were rarely done. Participants expressed low satisfaction with treatment.CONCLUSIONS: Current management of LBP at PHC level appears to be ineffective and not conform guidelines. Further South African research should focus on barriers as well as measures to be taken for implementation of LBP guidelines.
MULTIFILE
