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Geneva, Switzerland, WHO, 1977. 28 p. (OCP/STAC/77.2)The STAC (Scientific and Technical Advisory Committee) is evaluating the feasibility for economic development in the Volta River Basin. The main obstacle is the danger of onchocerciasis which could lead to blindness. The onchocerciasis control program hopes to reduce the disease to a low enough level that it no longer poses a major health problem or an obstacle to socio-economic development as well as to maintain the disease at a tolerable level. Therefore, studies, plans, and recommendations on insecticides are being made. The program is treating waterways with Abate, a biodegradable larvicide, in addition to undertaking parasitological surveillance. Blackflys are captured and their larvae are analyzed; data is recorded; and tests are conducted to detect any insecticide resistance. The STAC also examined villagers to diagnose human microfilariae in their skin and determine if eye lesions were present. Treatment currently used to combat the disease is either by nodulectomy and/or chemotherapy, but neither is fully effective and mass treatment is difficult. Metrifonate is a promising drug which affects the microfilariae in the cornea without irritating the anterior segment of the eye. Although there are some difficulties in overcoming onchocerciasis, reclamation of the valleys will benefit the population.
New York, New York, UNFPA, . ix, 66 p.This paper discusses Sri Lanka's population policy with special focus upon UNFPA's role in establishing and implementing a successful multi-sectoral family planning program for the country. Progress made in the past years must continue, while ongoing efforts are made to attain the goal of 2.1 TFR by year 2000. A suitable program must be better coordinated with a view to cutting waste and duplication, guarantee an adequate supply of appropriate contraceptive supplies, streamline research operation, more fully implement its educational programs, and recognize women's centrality in population programs, and recognize women's centrality in population programs. UNFPA assistance should be offered to effect such programmatic change and development, with service delivery needs addressed 1st. The Government of Sri Lanka lacks adequate resources to supply calls for an integrated approach focused upon creating a National Coordinating Council; developing a more sophisticated and targeted approach to information, education, and communication; providing contraceptive supplies, software for service delivery, and client counseling; training providers; and improving coordination with other multilateral programs for child care and human resource development. The present population and development situation, the national population program, proposed sectoral strategies for implementation, the role of technical assistance, and general recommendations for external assistance are discussed in detail.
AMERICAN JOURNAL OF PUBLIC HEALTH. 1990 Oct; 80(10):1188-92.Health trends since 1950 in both developed and developing countries are classified and discussed in terms of causative factors: socioeconomic development, cross-national influences and growth of national health systems. Despite the vast differences in scale of health statistics between developed and developing countries, economic hardships and high military expenditures, all nations have demonstrated significant declines in life expectancy and infant mortality rates. Social and economic factors that influenced changes included independence from colonial rule in Africa and Asia and emergence from feudalism in China, industrialization, rising gross domestic product per capita and urbanization. An example of economic development is doubling to tripling of commercial energy consumption per capita. Social advancement is evidenced by higher literacy rates, school enrollments and education of women. Cross-national influences that improved overall health include international trade, spread of technology, and the universal acceptance of the idea that health is a human right. National health systems in developing countries are receiving increasing shares of the GNP. Total health expenditure by government is highly correlated with life expectancy. The view of the World Bank and the International Monetary Fund that health care should be privatized is a step backward with anti-egalitarian consequences. The UN Economic Commission for Africa attacked the IMF and the World Bank for promoting private sector funding of health care stating that this leads to lower standards of living and poorer health among the disadvantaged. Suggested health strategies for the future should involve effective action in the public sector: adequate financial support of national health systems; political commitment to health as the basis of national security; citizen involvement in policy and planning; curtailing of smoking, alcohol, drugs and violence; elimination of environmental and toxic hazards; and maximum international collaboration.
New England Journal of Medicine. 1983 Fall; 61(4):659-86.In this examination of Saudi Arabia's health care accomplishments, it is argued that the World Health Organization's primary health care model is not the most appropriate for Saudi Arabia and countries like it. Saudi Arabia's health care policy is closely linked to its very rapid emergence as a new and distinctive society. Whereas most developing countries export physicians, Saudi Arabia imports them because the demand for physicians services cannot be met by the supply of indigenous physicians. Saudi health care development is very different from that of most of the third world. Although the country does have a great deal of western technology, Saudi Arabia seems to be following a different course of development from both the third world and the West. Unlike the West, the cost of medial technolgoy is not a problem for Saudi Arabia. Rather, it solves the problem of how to allocate its oil wealth to maintain political stability. The Saudis intend to make the best health care available to all its citizens; they are very concerned about the effect of modern technology on tradition. Therefore, the selection of technology is based on its cultural compatability, rather than on its costs. Primary care may be more technological and specialized than in the West. In Saudi Arabia primary health care may eventually be delivered entirely by specialists, rather than by general or family practitioners. The Saudis are expected to develop a health care system that will meet their particular needs. As with Saudi Arabia itself, health care is experiencing unprecedented change. Thus, the emerging Saudi system will be unique and innovative. Some of its accomplishments will be adopted by other developing countries; Western countries may look to Saudi Arabia as a natural laboratory of health care experimentation.
WHO CHRONICLE. 1980 Feb; 34(2):47-52.The Council for International Organizations of Medical Sciences (CIOMS) devoted their 1979 conference to the subject of economics and health policy. The discussions were held in 4 main sessions: 1) economic context of health problems and services; 2) economic aspects of health service manpower and technology; 3) financial implications of health services organization; and, 4) conclusions on requirements for future research and policy. Summaries stressed the importance of primary care and the need for prudent use of advanced technologies to control rising health costs. In spite of great differences between free market and centrally planned economies, the trend is toward a convergence of all health care systems. Agreement was reached on the fundamental importance of socioeconomic factors in determining health status; need to eliminate waste and improve cost-effectiveness, including more downward delegation of tasks (paramedical personnel and midwives); and the principle of equal distribution of services in populations. Research is needed into the effects of financing and remunerations in developing countries, cost-effectiveness of health care procedures, better matching of skills to tasks, socioeconomics developments in improving health.
WHO CHRONICLE. 1980; 34(1):20-3.In order to fulfill the goal of "health for all by the year 2000," the countries of Southeast Asia must be encouraged to establish comprehensive drug policies. This would remedy the present situation where access to life-saving drugs and essential drugs is limited and national health resources are wasted on less important medicines. The comprehensive drug policy could streamline every aspect of the pharmaceutical and supply system, ensuring high quality, safety and efficacy of the drugs. Each country's ministry of health should coordinate the program with aid from the WHO Regional Committee. Technical cooperation among the countries of the region is essential and establishment of eventual self-sufficiency with respect to essential drugs is encouraged. Traditional medicine and traditional medical practitioners should be integrated into the existing institutional system. Training of traditional practitioners in the preventive and promotive aspects of primary health care would improve the existing system. Since there is a lack of pharmacists in the region, the training of additional pharmacists should be a priority item in any new comprehensive drug program.
World Health. 1979 NOv; 6-9.Health is not just the absence of disease or infirmity but the state of complete physical, mental, and social well-being, according to the WHO Constitution. The presence and extent of endemic diseases, the environment, population increase, and health services available are predictable and controllable factors which need addressing. The foremost problem is the establishment of clean and safe water supplies. Immunization against diseases such as smallpox, diptheria, tetanus, poliomyelitis, tuberculosis, and measles is needed along with nutrition education and pre and postnatal care for women and infants. Under the heading of "improved standards of living" comes literacy and economic welfare which can contribute to or impede efforts to attain good health for all by the year 2000. Political upheavals can hamper the implementation of health plans. The countries that most need political stability are the ones plagued by drastic and frequent changes of their political systems. Military hostilities may result in devastation, famine, epidemics, and other health influencing types of suffering. International organizations are required to play a leading role in affecting world public opinion and reducing the suffering resulting from military hostilities and oppressive regimes. If the target of Health for All is to be achieved, many groups will have to cooperate to attain it.
PRACTITIONER. 1979; 223(1337):611-2.Since the term "family planning" was 1st introduced into medical terminology approximately 50 years ago, the movement has grown and expanded. What was originally intended as contraceptive services for married women, usually of high parity and low socioeconomic status, has spread to unmarried women. When family planning clinics were taken over by and incorporated into the National Health Service, the original role of the Family Planning Association became less clearly defined. Family planning services today include sex education, sexual sterilization, research into reversible methods of sterilization, research into the effect of oral contraceptives on general sex behavior, and infertility clinics. New technological advances in the field of fertility, e.g., artificial insemination, cannot be justified by the health needs of the parents or the social need to lower population. There is some question as to whether public funds should be spent to gratify what are sometimes selfish parental concerns.
WHO CHRONICLE. 1979 Nov; 33(11):399-406.The World Health Organization's "health for all" goal by the year 2000 appears to be a formidable task. However, many possible obstacles have already been identified, and realistic appraisal of resources suggest that it is possible to overcome these obstacles. Science and technology, along with political commitment and appropriate social organizations have significant roles to play in achieving the health for all objective. For developing countries, political commitment means the allocation of a greater share of health resources to the underserved majority of the population. The current picture of the world health situation shows that approximately 4/5 of the world's population are disadvantaged because of grossly inadequate and sometimes inaccessible systems of health care. Some of the major health problems plaguing the developing world are: l) communicable diseases, including parasitic infections; 2) other diseases such as cancer; cardiovascular and metabolic diseases; mental disorders; 3) environmental health problems (contaminated water; inadequate sewage and waste disposal facilities; poor food hygiene; inadequate housing); 4) minimal standards of family health and planning; 5) inadequate provision of essential pharmaceuticals; 6) use of traditional medicine; 7) psychosocial factors; 8) high technology and costly materials; 9) a great lack of appropriately trained technicians; l0) unavailability of relevant health information; and ll) weak institutional infrastructure.
In: Singh JS, ed. World Population policies. New York, Praeger Publishers, 1979. 228 p.The World Population Plan of Action synthesizes major points raised at the 1974 Bucharest Conference and numerous United Nations resolutions between 1966-74. Population and development are interrelated. Individuals and couples have the rights to decide freely the number and spacing of their children and should have the knowledge and means to do so. Population policies, programs, and goals are to be formulated and implemented at the national level within the context of specific economic, social, and cultural conditions of the respective countries. International strategies cannot work unless the underprivileged of the world achieve a significant improvement in their living conditions. It is recommended that countries with population problems impeding their development establish goals for reducing population growth by 1985. A life expectancy of 50 years is another suggested 1985 goal; also infant mortality rates of less than 120/1000 live births. Networks of small and medium sized cities should be strengthened for regional development and population distribution. Fair and equitable treatment is urged for migrant workers. Population measures, data collection, and population programs should be integrated into economic plans and programs. Total international assistance for population activities amounted to $2 million in 1960 and $350 million by 1977.
JOURNAL OF THE INDIAN MEDICAL ASSOCIATION. 1979 Mar 16; 72(6):137-43, 148.The International Conference on Primary Health Care called for urgent and effective national and international action to develop and implement primary health care throughout the world. All government agencies should support primary health care by channelling increased technical and financial support to health care systems. Any national health policy designed to provide for its people should recognise the right to health care as a fundamental right of people. The sociocultural environment of the people should be upgraded as a part of health care. The government's expenditure on health should be regarded as an investment, not as a consumption. Health should be a purchasable commodity. Medical education should be reoriented to the needs of the nation. The government should establish as its ultimate goal the provision of scientific medical service to every citizen. Industrial health and mental health disciplines should establish clear-cut methodologies to achieve the same objectives as medical science. Practitioners of indigenous systems of medicine should be allowed to practice only those systems in which they are qualified and trained. Integration of the modern and traditional systems has failed. In order to encourage people to adopt small family size, facilities for maternal and child welfare clinics, coupled with immunisation and nutrition programs, are needed.
WHO Chronicle 33(6):203-208. June 1979.The Action Programme on Essential Drugs is an internationally-sponsored program of technical cooperation which was started by the World Health Orgnaization (WHO). The Program aims to: 1) strengthen national capabilities of developing countries in selecting, supplying, distributing, and using essential drugs; 2) strengthen local quality control and production, where possible, of such drugs; and 3) provide essential drugs and vaccines to developing countries. Drugs considered essential will differ from 1 country to another depending on available medical personnel and prevalent diseases. In the next several years, development of primary health services will go concurrently with development of pharmaceutical supply systems adapted to the specific needs of the country's population. Technical cooperation should be facilitated through international assistance. Current activities of the Program in each of the WHO regions are summarized.