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  1. 1
    051432

    The eradication of smallpox: organizational learning and innovation in international health administration.

    Hopkins JW

    JOURNAL OF DEVELOPING AREAS. 1988 Apr; 22(3):321-32.

    The WHO smallpox eradication campaign represents perhaps the best example of a successful international health administration. In the 1st year of the campaign (1967), the guiding strategy was to vaccinate people en masse over a 2-3 year period in countries where smallpox was epidemic thereby conquering the disease. In Western Nigeria where >90% of the population had been vaccinated, a smallpox outbreak occurred in a religious sect resisting vaccinations and a delay in delivery of supplies forced a change in strategy. Campaign staff learned to rapidly isolate infected persons and swiftly vaccinate the uninfected in an outbreak area in order to break the transmission of smallpox, even where <1/2 the population had been vaccinated. Technological advancements also contributed to the campaign's success. For example, the jet injector vaccinated >1000 people/hour with efficient, reliable, mass produced potent, stable freeze dried vaccines (often produced in target countries) or the less costly and virtually maintenance free bifurcated needle was used. The most significant contribution to the success of the campaign, however, was the flexible mode of management adopted by the campaign staff at WHO which provided an appropriate environment for organizational learning and innovation. Although management was open and flexible, the campaign did depend on careful planning and setting of goals, continual assessment, and rapid response to field requests for assistance or advice. Trends in the incidence of smallpox was chosen as the indicator of success as opposed to the number of vaccinations. The campaign demonstrated the need for cultural adaptations as it operated in each country and region. This evaluation of the success of the smallpox campaign presents conclusions that serve as guidelines to the organization and administration of international programs designed to solve other health problems.
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  2. 2
    077200

    The role of international agencies, governments, and the private sector in the diffusion of modern contraception.

    Sai FT; Nassim J

    TECHNOLOGY IN SOCIETY. 1987; 9(3-4):497-520.

    This paper views diffusion as encompassing three processes: the acceptance of the idea and practice of contraception by consumers; the establishment of the institutions or programs to provide services; and the development of technical capability in research and development and in the production of contraceptives. The historical development of the family planning movement is described, and the contribution of international agencies, governments, and private sectors is discussed in the context of changing development approaches. Substantial achievements have been made, but, in view of future needs and the uncertainty of political and financial commitment to family planning on the part of donors, the future presents a continuing challenge. (EXCERPT)
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