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WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (749):1-86.This report makes a special effort to present practical information on the control of intestinal parasitic infections. It covers the following: public health significance of intestinal parasitic infections (methods of assessment, helminthic infections, and protozoan infections); the costs of not having a control program (nutrition, growth, and development; work and productivity; and medical care); prevention and control strategies (epidemiological foundation, objectives and general approaches, implementation strategies, costs and financing, methodologies and tools, and strategy for prevention and control); national programs (justification; objectives and strategies; planning; program and implementation; training, education, and dissemination of information; program monitoring and evaluation; and technical guidance); and program support (the role of the World Health Organization, technical and research organizations, funding agencies, industry, and information flow). Current experience suggests that intestinal parasite control programs are appropriate and socially advantageous because people can actually see the effects of primary health care intervention and start to learn some simple facts about health care by watching their village or community become healthier as a result of the control measures. There are 3 major areas in which the lack of control program is responsible for significant losses: nutrition, growth, and development; work and productivity; and medical care costs. Countries in which intestinal parasitic infections and diseases constitute a significant health problem need to consider adopting a national policy for their prevention and control. Recent experience in various countries has demonstrated the effectiveness of periodic deworming and standard case management at the primary health care level in reducing most of the problems associated with intestinal parasitic infections. Support can come from outside the country as well as from national authorities. Support from the outside may be available in the areas of management, technical expertise (which includes research), funding, and exchange of relevant information. The World Health Organization can provide both technical and managerial expertise in the design of programs.
PUBLIC HEALTH REPORTS. 1980 Sep-Oct; 95(5):422-6.The implications of the eradication of smallpox in the context of epidemiology are presented. Eradication of disease has been conceived since the 1st smallpox vaccination was developed in the 18th century. Since then, attempts to eradicate yellow fever, malaria, yaws and smallpox have been instituted. Most public health professionals have been rightfully skeptical. Indeed, the success with smallpox was fortuitous and achieved only by a narrow margin. It is unlikely that any other disease will be eradicated, lacking the perfect epidemiological characteristics and affordable technology. The key to success with smallpox was the principle of surveillance. This concept has a vigorous developmental history in the discipline of epidemiology, derived from the work of Langmuir and Farr. It involves meticulous data collection, analysis, appropriate action and evaluation. In the case of smallpox, only these techniques permitted the key observations that smallpox vaccination was remarkably durable, and that effective reporting was fundamental for success. The currently popular goal of health for all, through horizontal programs, is contrary to the methods of epidemiology because its objective is vague and meaningless, no specific management structure is envisioned, and no system of surveillance and assessment is in place.
Geneva, Switzerland, WHO, 1985. 110 p.3 World Health Organization (WHO) Scientific Groups have examined different technical aspects of the problem of sexually transmitted diseases and their reports have been published in the Technical Report Series. This book has been prepared following the meeting of a scientific working group that was held in Washington in April 1982 to discuss the formulation of appropriate strategies and programs for the control of this group of diseases. This book emphasizes the need for such programs to be integrated into general programs for the control of communicable diseases and for the gynecologcal, obstetric, pediatric, and urological services to play an active and dynamic part. A control activity for sexually transmitted diseases is any activity which minimizes the adverse health effects of this group of diseases. Control activities may reduce the incidence of the disease; the duration of the disease; the effects of each case, including both the physical complications and psychosocial consequences; or the cost of achieving certain outcomes, i.e., increase the efficiency of services. Many different control activities, for example, clinical services, screening, and contact tracing, can reduce the effects of sexually transmitted diseases. A control program is composed of various control activities. Priorities are established, various options for control are examined, and appropriate methods are adopted. Control programs for sexually transmitted diseases define the population to be covered and specify the control activities related to that group. The 1st section of this book covers initial planning steps, focusing on estimating the public health importance of sexually transmitted diseases, priority groups, and sociological aspects of control. The section devoted to intervention strategies deals with health promotion, disease detection, national treatment programs, contact tracing and patient counseling, and clinical services. The 4 chapters that make up the support components section discuss centers for prevention of sexually transmitted diseases, information systems, professional training, and laboratory services. The 2 chapters devoted to implementation examine program management and evaluation of control programs. This book may appear to suggest that the disease control process should be highly systematic, comprehensive, and compartmentalized. Yet, in practice, many activities take place simultaneously and in a manner that is far from systematic, sequential, and ordered.
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.