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JOURNAL OF HEALTH AND SOCIAL BEHAVIOR. 1989 Dec; 30(4):345-52.Third World originated in the 1950s as a political ideology and concept. As an empirical reality it is a world characterized by economic underdevelopment. Attention is beginning to focus on its cultural and human aspects, including health and health care. The 9 articles in this special issue show the application of sociology to the study of 3rd World health and health care. The articles are classified into 4 categories--social factors in disease, utilization of health services, provider-patient relationships, and organization of health services. Their relationship to research issues and methods in medical sociology is discussed. In conclusion, the World Health Organization's (WHO) "Health for ALL" program is critiqued in light of finding in the articles. 2 topics require closer sociological analysis than they have received, and these are discussed. The 1st concerns health manpower, especially the role of the physician, in relation to 3rd World health priorities. The 2nd is the place of traditional health personnel and practices within the general development of national health resources. Given the high regard for technical clinical skill that is imparted through medical education worldwide, it is not clear that 3rd World physicians can be persuaded to become health educators or coordinators for social resources, however necessary those functions may be. Even so, the Health for All agenda can switch to another priority, namely, the radical reform of medical education to produce physicians who are more strongly oriented toward goals of community health and less concerned with technical skill. (author's modified)
In: Women's health and apartheid: the health of women and children and the future of progressive primary health care in Southern Africa, edited by Marcia Wright, Zena Stein and Jean Scandlyn. New York, New York, Columbia University, 1988. 84-9.There is a large discrepancy between maternal mortality rates in developed and developing countries, with maternal mortality as a leading cause of death of young women in poor countries. There has been renewed interest in maternal mortality among international agencies and major foundations quite recently. Women and children form up to 2/3 of the population of many developing countries, and over 1/2 of primary health care resources are devoted to maternal and child health programs. Nevertheless, little of this is directed at maternal mortality; most goes to immunization, oral rehydration for diarrhea, monitoring children's growth, and promoting breastfeeding. While some of the international health community attribute the long neglect of maternal mortality to not knowing the extent and severity of the problem before, prior data existed demonstrating the alarmingly high rates. Low maternal mortality in the West may have distracted attention from the international problem. Sexism may have been a major factor, as even today efforts to reduce maternal mortality need to be justified in terms of the implications for the family, children and society as a whole. The reasons for the current concern are not clear, but may relate to an interest in concrete issues after the United Nations Decade for Women, or real surprise in the international community once the problem was pointed out. As various agencies rush to establish maternal mortality programs, it is imperative to evaluate which approaches will be really effective. Critical evaluation of programs is necessary to capitalize on the current interest.
Population Bulletin of the United Nations. 1976; (8):1-15.This article assesses the extent to which demographic research has been affected by the World Population Conference at Bucharest. The broadening of the scope of the population concept brought about at Bucharest is discussed and 7 major points established there are listed. The 3 main sources of demographic data, censuses, vital statistics, and surveys, are examined to determine to what extent they are adaptable to the need for enlargement called for by the Conference. It is suggested that a "demographic observatory" be established to monitor not just fertility but all the population variables as set forth in the World Population Plan of Action. Needed research in fertility studies, morbidity and mortality, international migration, internal migration and rural development, population and development, projections, integration of population in economic planning, and other areas is indicated. In the future, attempts to explain population phenomena will need to go beyond demography itself, and this will call for true interdisciplinary cooperation in place of narrow specialization. Reorganization of research is needed, and a determined effort is necessary to establish new directions while protecting the freedom, scientific neutrality, and structures of the disciplines.