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  1. 1

    Planner's approaches to community participation in health programmes: theory and reality.

    Rifkin SB

    Contact. 1983 Oct; (75):1-16.

    Investigates health planners' assumptions about community particiation in health care. Primary health care aims to make essential health care accessible to all individuals in the community in an acceptable and affordable way and with their full participation. It is the strategy propagated by the World Health Organization to provide health for everyone by the year 2000. Community participation is seen as the key to primary health care and has raised many assumptions and expectations among health planners. Community people are seen as a vast untapped resource which can help to reduce the cost of health care by providing additional manpower. It is also expected that community people want to participate in their own health care because they wish to serve their community and to have a part in decisions which affect them. In the early 1970's, programs were developed out of church-related efforts. They pioneered many of the ideas which became principles of primary health care. The church-related programs were nongovernmental and therefore flexible. They had the same goal of letting the community take responsibility for their own health care; program planners were primarily medical people trained in Western medicine. The planners were concerned with the plight of the poor. However, the programs tended to reflect planners' hopes for, rather than the community's understanding of, the community health problem. The author concludes that the assumptions that planners make about their programs need to be critically analyzed. Investigations need to be made into community perceptions and expectations of their role in health programs. Studies need to be undertaken to identify the potentials and problems of community participation and the record of established community health care programs needs to be examined.
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  2. 2

    The south-east Asia region.

    Zaman H

    In: Bannerman RH, Burton J, Ch'en Wen-Chieh. Traditional medicine and health care coverage: a reader for health administrators and practitioners. Geneva, Switzerland, World Health Organization, 1983. 231-9.

    This article discusses the status and functioning of the major systems of traditional medicine in Southeast Asia with particular attention to the activities of WHO. Decision regarding traditional medicine taken by health and political authorities in congresses and conferences from 1977 to 1979 are outlined. Intercountry projects to promote traditional medicine including 1 begun by WHO in 1978 and another 1 founded by the United Nations Development Programme in 1982 are described. The major systems of traditional medicine practiced in the region can be classified as 1) formalized systems which include Ayurveda, Siddha, Unani-Tibbi, the chinese system of medicine, and 2) non-formalized, traditional systems of medicine practiced by herbalists, bonesetters, practitioners of thaad (element system), home remedies and spiritualists. In addition yoga, nature cure and homeopathy are being practiced in some countries including Bangladesh and India. Almost all the countries have recognized the traditional systems of medicine and are making efforts to utilize the practitioners in their health care delivery programs. There are at present 750,000 practitioners of traditional medicine in the region. Health programs in Bangladesh, Burma, India, Indonesia, Maldives, Nepal, and Sri Lanka are discussed. Future efforts of WHO in the region will be related 1st, to reorient traditional healers to meet the needs of primary health care; and 2nd to support research on the treatment of diseases for which modern medicine has no cure, such a peptic ulcer, bronchial asthma, rheumatoid arthritis, urolithiasis, viral hepatitis, and diabetes mellitus.
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  3. 3

    [The strategy of health for all in all its magnitude] Estrategia de salud para todos en toda su magnitud.

    Mahler H

    Boletin de la Oficina Sanitaria Panamericana. 1983 Oct; 95(4):361-6.

    Around 1970, interest in the concept of social justice began to be reflected in analyses of health systems in developing countries, and in the rapid acceptance and popularization of the goal of health for all by the year 2000, to be achieved through primary health care programs providing universal coverage. UN member states can maintain the impulse to provide universal health care by carrying out within their borders the health care policies collectively recommended by the UN General Assembly, aided by the World Health Organization (WHO) which has put aside the paternalistic policies of the past and which now seeks to assist nations in carrying out their own goals. 1 step in assuring that the goals will be met involves continual surveillance of the progress of implementation, which is to be reported in various meetings and conferences at regional levels and at the World Health Assembly in 1984. Identification of problems in implementation should not be interpreted as placing blame, but rather as signalling the need to search for common solutions to them. New principles in the use of WHO aid are that the member governments should assume responsibility for the application in their countries of the jointly agreed upon policies as well as the utilization of WHo resources reserved for that end, that WHO resources be used only for activities compatible with policies defined at the national and international levels; that WHO resources be used to achieve adequate planning and administration of the health infrastructure, with assistance from WHO; that individual countries participate in evaluation of WHO sponsored activities to assure the optimal use of resources; and that countries assume much greater responsibility for the use of WHO resources. Application of the new principles will require a new type of interaction with the various organs and personnel of WHO at different levels. External aid which requires excessive concentration on only 1 aspect of health care, such as immunization or control of some forms of diarrhea, is counterproductive and continues past tendencies to impose health goals and programs from outside.
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  4. 4

    Seventh General Programme of Work, covering the period 1984-1989.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 1982. 153 p. (Health for All Series, No. 8)

    This document contains the World Health Organization's (WHO's) 7th General Programme of Work for the period 1984-89 as approved by the World Health Assembly in May, 1982. WHO's major task between 1984-89 will be to provide coordination and technical support for the development, implementation, monitoring, and evaluation of strategies for attaining the world's goal of health for all by 2000. WHO will seek to strengthen primary health care (PHC) systems in member states by promoting the use of appropriate technology, by assisting in the development of health systems for the delivery of integrated services, and by encouraging a high level of community participation in health care systems. The 4 major components of the program are 1) the direction, coordination, and management of the overall program; 2) the development of health system infrastructures; 3) the collection and dissemination of information on health technology and science and support for research to develop new health technologies; and 4) program support. In reference to the 1st component, WHO, through its governing bodies, i.e., the World Health Assembly, the 6 regional committees, and the executive board, will seek to maintain a unity of purpose and direction for the program as it is implemented in each country and region. In regard to the 2nd component, WHO will provide assistance for 1) collecting the information required for effective health planning 2) conducting research aimed at determining optimal organizational structures for PHC systems, 3) determining if legislation is needed to facilitate the development of effective and efficient health systems, 4) ensuring the efficient management of health systems, 5) mobilizing the required health manpower, 6) engendering support for the program among health personnel and policy makers, and 7) monitoring and evaluating the program. The health sciences and technology component will deal with the content of health care. Existing technologies for diagnosing, treating, preventing, and controlling specific disease must be evaluated in reference to their appropriateness for inclusion in health systems. Research to develop new technologies will also be encouraged. Specific programs will focus on nutrition, oral health, accident prevention, maternal and child health, family planning, reproductive health, worker safety, the elderly, mental health, environmental health, diagnostic technology, therapeutic and rehabilitation technology, and the prevention and control of numerous communicable, infectious, and noncommunicable diseases. WHO's support component will provide primarily health information and administrative support.
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  5. 5

    Gambian Primary Health Care Resource Group (First meeting, Banjul, 7 - 9 June 1982).

    World Health Organization [WHO]. Health Resource Group for Primary Health Care

    [Geneva, Switzerland], WHO, 1982. 17 p. (HRG/CRU.1/Rev.1/Mtg.1)

    In 1979, a WHO team collaborated with national personnel in The Gambia in developing a comprehensive primary health care (PHC) plan of action for the period 1980/81 - 1985/86. In his address to the legislature in August, 1980, the president declared that the plan involved the active participation of local communities and emphasized programs for health promotion and disease prevention. This monograph reports on a meeting of the Gambian Ministries of Economic Planning and Industrial Development and of Health, Labor and Social Welfare in June 1982. Improvements in rural health are a basic need. In order to provide PHC, it was fully realized that a strong supportive infrastructure was essential. The village sensitization program was considered as vital for success. Not 1 village has rejected PHC or its responsibilities. The training program for community health nurses, village health workers and traditional birth attendants was proceeding according to plan for the various levels. Recognizaing that an efficient drug supply was essential, concomitant action had been taken to reorganize the central store. Another essential element without which success could not be achieved related to provision of transport and facilities for their maintenance, so that communications could be assured with rural areas. The need for a radio network to link 6 staions and 26 sub-stations was stresses. The list of participants and the agenda are attached as are the requirements for external support for the planned provision of PHC which were considered by the participants of the meeting.
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