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  1. 1
    266293
    Peer Reviewed

    Grass roots, herbs, promoters and preventions: a reevaluation of contemporary international health care planning. The Bolivian case.

    Crandon L

    Social Science and Medicine. 1983; 17(17):1281-9.

    In evaluating a United States Agency for International Development (USAID) project in Bolivia, the author argues that the program unwittingly contributed to the situation that created Bolivia's political problems. A 5-year pilot project which covered 39 villages and colonies in the Montero district in the state of Santa Cruz began in 1975 and was completed in 1980. In 1980 the project was "deobligated" when all but essential economic aid to Bolivia was halted following a political coup. The pilot project was based on 1) community participation through health care; 2) a referral system from health post of the promotor to the center with an auxiliary nurse midwife, to secondary and tertiary care in hospitals by physicians; 3) an emphasis on preventive medicine; and 4) the use of traditional medicine along with other therapy by the promotor. Although these concepts sound appropriate, they are in fact derived from contemporary thought in advanced industrial societies. The assumptions about social reality that are inherent in these plans actually misconstrue Bolivian society. The unintended consequences of the project actually diminish rural health care. A difference between the Western health planner's conception and the Bolivian conception--of community, of effective referral systems, of preventive and indigenous medicines--can have the effect of producing a health care program that has little resemblance to what was originally intended. The Bolivian elite actually manipulated the USAID health care programs through hegemony in the villages. The Jeffersonian concept of community is not applicable in Bolivia where resources are only exchanged through personal contacts. In villages of multiple class or ethnic groups or both or in villages with close ties or histories of ties with larger, more cosmopolitan groups, multiple different interests exist. These work against each other to prevent the very cooperation envisioned by the health care programs. The author suggests that developed countries should consider native ideologies, native social relations, and indigenous medicine more sensitively in design.
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  2. 2
    267140

    Aging: a matter of international concern, statement made to the world Assembly on Aging, Vienna, Austria, 27 July 1982.

    Salas RM

    New York, N.Y., UNFPA, [1982]. 9 p. (Speech Series No. 78)

    This statement discusses the rising proportion of the aged in the total population of both developed and developing countries, causing psychological, economic, social and spiritual needs. The aging of the population is the consequent phenomenon of the demographic transition, that is the reduction of fertility and prolongation of life expectancy. People aged 60 or over constitute 15% of the population of developed nations in 1975. It is expected that by the year 2000, they will constitute 18% of the population. This transition called for programs for the welfare, health and protection of the aged. One of the most important issues facing both developed and developing countries is to insure that, in the process of industrialization, urbanization and social change, the valuable aspects of village and extended family life are not lost. UNFPA's agenda for the aging include data collection, research, support communication, collaboration with concerned institutions, and policy consultations.
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