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WORLD HEALTH. 1988 Jan-Feb; 10-11.In 1979 WHO invited its member states to participate in a global strategy for health and to monitor and evaluate its effectiveness using a minimum of 12 indicators. Members' 1982 implementation reports and 1985 evaluation reports form the basis for evaluating each measure. Indicators 1-6 have strong political and economic components in both developed and developing countries and are not complete. Indicator 7, for which rates of reply are satisfactory, asks whether at least 5 elements of primary health care are available to the whole population. The 8th gauge seeks information on the nutritional status of children, considering birth weight (a possible indicator of risk) and weight for age (a monitor of growth). Infant mortality rate and life expectancy at birth, indicators 9 and 10, are difficult to estimate in developing countries, and health services are not always kept informed of current estimates. Indicator 11 asks whether the literacy rate exceeds 70%; it can provide information on level of development and should emphasize literacy for women, for whom health information is critical. The last global measure yields information about the gross national product, which is not always the most recent, despite the trend of countries to publish their gross domestic product. Failure to make use of the best national sources, such as this, is one of several problems encountered by WHO's member states in collecting accurate data. Other problems include lack of universally acceptable definitions, different national accounting systems, disinterest of health authorities in economic matters, lack of staff, lack of financial resources in developing countries, and inadequately structured health system management. Each country must choose the most appropriate methods for collection of data. If an indicator cannot be calculated, the country is encouraged to seek and devise a substitute. WHO must produce more precise and reliable indicators. It must respond to requests for ways of improving or strengthening national systems.
Alternative approaches to meeting basic health needs in developing countries: a joint UNICEF/WHO study.
Geneva, World Health Organization, 1975. 116 p.Based on the failure of conventional health services and approaches to make any appreciable impact on the health problems of developing populations, this study examined successful or promising systems of delivery of primary health care to identify the key factors in their success and the effect of some of these factors in the development of primary health care within various political, economic, and administrative frameworks. In the selection of new approaches for detailed study, emphasis was placed on actual programs that are potentially applicable in different sociopolitical settings and on programs explicitly recognizing the influence of other social and economic sectors such as agriculture and education on health. Information was gathered from a wide range of sources; including members, meeting reports, and publications of international organizations and agencies, gathered country representatives, and field staff. The 1st section, world poverty and health, focuses on the underprivileged, the glaring contrasts in health, and the obstacles to be overcome--problems of broad choices and approaches, resources, general structure of health services, and technical weasknesses. The main purpose of the case studies described in the 2nd part was to single out, describe, and discuss their most interesting characteristics. The cases comprised 2 major categories: programs adopted nationally in China, Cuba, Tanzania, and, to a certain extent, Venezuela, and schemes covering limited areas in Bangladesh, India, Niger, and Yugoslavia. Successful national programs are characterized by a strong political will that has transformed a practicable methodology into a national endeavor. In all countries where this has happened, health has been given a high priority in the government's general development program. Enterprise and leadership are also found in the 2nd group of more limited schemes. Valuable lessons, both technical and operational, can be derived from this type of effort. In all cases, the leading role of a dedicated individual can be clearly identified. There is also evidence that community leaders and organizations have given considerable support to these projects. External aid has played a part and apparently been well used. Every effort should be made to determine the driving forces behind promising progams and help harness them to national plans.
A national approach to health service management information services. The work of the English Steering Group on Health Services Information.
[Unpublished] 1984. 23 p. (WHO/HS/NAT.COM/84-387)In February 1980 the Secretary of State for Social Security appointed the joint National Health Service/Department of Health and Social Security Group on Health Services Information to conduct the 1st comprehensive review of national health services (NHS) management information services since the inception of the NHS. The 1st report presents the Group's conclusions and recommendations about the information required by management regarding clinical facilities and departments in hospitals and the patients using them. In due course this report will be followed by reports on information about community services, paramedical services, personnel, finance, patient transport services, dental service, and other areas of interest. The Steering Group's approach to its task has been based on the requirement to collect data because they are essential for operational purposes. The Group also aims to establish a series of minimum data sets, covering the major areas of management activity in the NHS, to provide the information needed by a district health authority and its officers to manage health services, and to actively influence the allocation of services. The Group began with a review of existing data systems. Working groups were established to investigate hospital facilities used by consultant medical staff, laboratory and scientific services, paramedical services, community health services, health service personnel, health service management accounting, and patient transport services. The smooth implementation of recommendations requires training of the staff responsible for data collection. In formulating proposals, focus has been on the information required by a district health authority and its officers. It is believed possible to identify a minimum set of data which should be used in all districts and that the data should be collected largely as a byproduct of operational procedures. The approach to information for management postulates that the needs of the district tier of the NHS are paramount. In developing the district minimum data set, the working groups paid particular attention to the following characteristics of data: relevance; timeliness; and ability to be collated with data from other sources. Statistical information about the clinical services in a district is drawn from activity data, health services personnel data, and financial data. The major areas of clinical work can be categorized as services provided on hospital premises, off hospital premises, and in or for the community. This report is a synthesis of the recommendations of the 2 working groups which have reviewed the data required about the activity of: the services provided on hospital premises (except radiotherapy); the services provided in consultant outpatient clinics; the services provided in day care facilities; and the services related to a registrable birth. Recommendations are summarized.
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. 194-206.There is a genuine interest now being taken in phytotherapy and medicinal plants throughout the world. In industrialized countries there is a trend of going back to nature or wanting to combat the chemical pollution of the body provoked by inopportune chemotherapy or by the misuse of convenience drugs of chemical origin; third world countries are primarily concerned with providing their peoples with adequate coverage of their essential drug needs. A new type phytotherapy is proposed, to produce phytotherapeutic preparations for use in modern medical practice from the resources of traditional medication. In view of difficulties experienced by developing countries in meeting their needs for essential drugs, 4 measures might be taken to encourage utilization for primary health care of their vast local resources: 1) a real health policy option at national and regional level; 2) determination of priorities regarding health problems and definition of possible solutions; 3) goal-oriented applied scientific research on medicinal plants, incorporating properly planned programs; 4) effective implementation of these programs with regard to technical and financial resources and appropriate personnel. Cooperation among developing countries, with the industrialized countries and with organizations of the United Nations system is recommended. A table illustrates integrated overall organization.