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Health and Population: Perspectives and Issues. 1982 Jan-Mar; 5(1):23-33.A new discipline, health economics, which reflects the relationship between the health objective procuring adequate health care and the financial resources available, is becoming increasingly important. The WHO definition of health, that health is a "state of complete physical, mental and social well being and not merely the absence of disease or infirmity," is criticized for not lending itself to direct measurement of the health of the individual or community. This concept should include consideration of the process of being well as well as the absence of disease. It must also recognize that services to promote health, to prevent, diagnose and treat disease and rehabilitate incapacitated people must be included in the concept. For economic analysis purposes, health services can be classified into medical care, public health services and environmental public health services. It is suggested that the cost of education and training of medical personnel and medical research should be included in computing the cost of health services. In defining economic concepts many factors including capital and current costs, and depreciation must be considered. In addition all health economists have differentiated the direct cost of sickness including cost of prevention, detection, treatment, rehabilitation, research, training, and capital investments from indirect costs which include loss of output to the economy, disability and premature death. Using these concepts, some understanding of cost trends, cost accounting, cost benefit analysis and cost efficiency analysis should be made available in the medical curriculum and for health administrators so that health management can be more standardized and effective. (summary in HIN)
Journal of Modern African Studies. 1982; 20(1):45-67.Discusses the question of government policy toward control of population growth in its relation to economic development, especially in Africa, where population growth rates are high and the rate of economic growth very low. The author reviews the debate between supports of Marx and Malthus, and the family planning versus development debate which he sees as evolving from it. Merit may be found in the arguments of all sides, but some middle ground between the radical positions must be found. It must be recognized that a population problem exists, and that family planning can play a supportive role in keeping fertility rates down, but that a certain level of socioeconomic development must be reached before much can be done about the problem while recognizing that high fertility is itself and impediment to reaching this level of development. Cultural conditions leading to high fertility must also be considered, as well as the political and administrative dimension; both are briefly examined. The author concludes that assistance for population activities is worthwhile and desirable, but not at the expense of other areas of development which contribute to lowered fertility by themselves. The United States should review its policies with this in mind. In a postscript, the author notes that U.S. policy would appear to be undergoing review by the current administration; a shift towards urban Africa and towards encouragement of participation by private industry, evidently underway, would lessen the effect of U.S. development assistance on poverty and the high fertility rates in Africa.
Forum. 1982 Feb; 4(2):2-6.Traditionally, approaches to population policy have been largely conditioned by economic theories. The population dictum held that increased economic development would assure improved human development. Population control, along with increased economic productivity were seen to be the major determinants in increasing the quality of life for all. Later, a changed philosophy emerged with the realization that the issue was not a simple one--human factors had to be considered, and economic goals should not be sought at the expense of social dislocation. In particular, education, health, human rights and other interrelated factors were considered integral to the development of population policy. Education was singled out as the key to informed and effective adoption of a rational population policy. The problem of funding for population policy implementation remains a delicate one. Logically, it must take the form of a balancing out of the inequities in economic resources within the society. More and more it is apparent that help must come from within--everyone must regard this problem as his own. In an era of international "stagflation," countries cannot be dependent on international aid. Most importantly, throughout the process of planning and development it must be kept in mind that the need, 1st and foremost, is to upgrade the human condition without regard for personal standing.
New York, Cambridge Univ. Press, 1982. 229 p.Describes research on how governments adopt population policies, how such policies are carried out, and the differences between programs that are implemented and those that are not; underlying ethical and moral issues are also considered. Based on a cross national study by the Hastings Center, with financial support by the United Nations Fund for Population Activities (UNFPA), major projects were carried out in Egypt, Kenya, Mexico and the Philippines, with smaller ones in the Dominican Republic, Haiti, India, and Lebanon, beginning in 1973 and continuing until 1981. An overview section describes the project and examines the question of theory for implementation and the influence of international donor agencies in the population field. Subsequent chapters consider the power of process in policy formation, the importance of the political, cultural and bureaucratic (inter and intraagency) contexts, review the impact of implementer commitment at all levels (with emphasis on field level), and explore the influence of outside opinion leaders and the power of clients in affecting program outcomes. Concluding essays 1) propose that implementation be viewed as a transaction rather than as a mechanical execution, a game, or programmatic evolutions; and 2) plead for an ethics of respect in population policy and propose specific guidelines for implementation. The focus on implementation is helpful in directing attention to organization behavior over proclamations.
[Current orientations and future perspectives of the International Union of Health Education] Union internationale d'education pour la sante orientations actuelles et perspectives d'avenir.
International Journal of Health Education. 1982 Oct; 1(2):57-64.In his report, Dr. E. Berthet, Secretary General of the IUHE, stresses the importance of 4 major concepts which should serve as the basis for all the activities of the Union: 1) health education is a major factor in economic and social development; 2) health education is not merely 1 more discipline amongst many but an attitude of mind, a way of thinking and acting which requires medical, psychological, pedagogic, social and economic data; 3) health education should neither blame nor moralize, it should not exploit human fear and pain, it should inform, on the basis of sound epidemiological data, about the major avoidable risks; 4) health education should avoid medical systematization of the social circumstances deriving from living conditions which have nothing to do with pathological conditions of the human body. In future, health education should take further steps and become part of the knowledge of all persons directly or indirectly responsible for economic and social development, e.g.: health professionals, particularly primary health care workers, teachers, leaders in private and public organizations, trade-unionists, social workers, decision-makers, mass media representatives. The latter should work in close cooperation with health professionals. The report also reviews the numerous meetings organized or sponsored since 5 September 1979 by the IUHE. During the last 3 years, working relationships between the Union and international institutions--particularly WHO, UNICEF, and UNESCO--have developed considerably. In May 1983 the technical discussions of the 36th World Health Assembly will be devoted to new health education policies in primary health care. After mentioning the financial difficulties the Union has to face and expressing his gratitude to all Union officers, Dr. Berthet concludes in the words of an oriental saying, that if you make plans for 1 year, grow some rice; if you make plans for 10 years, grow a tree; if you make plans for a century, teach the people. (author's modified) (summaries in ENG, SPA)
London, England, IPPF, 1982. 11 p. (IPPF Fact Sheet)The objectives of the Planned Parenthood and Women's Development Programme (PPWD) of the International Planned Parenthood Federation (IPPF) are: 1) to promote the status of women and family planning programs; 2) to promote cooperation between Family Planning Associations (FPAs) and other social agencies; 3) to broaden the FPAs membership base, and to increase involvement of volunteers; and 4) to involve women of reproductive age in decisions about the kind of family planning services provided. Guidelines for project development state that projects should be grassroots efforts that have a practical effect on women's lives, and should also include women's nonfamilial roles. IPPF normally provides funding only to family planning activities; however nongovernmental agencies, the United Nations, or governmental organizations that meet PPWD criteria can now be included. The four types of PPWD program activities are: 1) seminars and workshops; 2) legal reform/research; 3) training trainers; and 4) field projects. 3 models applicable to PPWD field projects are: 1) prefamily planning projects; 2) development projects that have a family planning component; and 3) family planning projects with development components. A project planning workshop is generally held before PPWD starts. Women running PPWD projects are being trained in management skills. Training manuals are being prepared. A PPWD Advisory Group was organized at the London IPPF office. There are now over 100 PPWD-type projects undertaken and funded by the FPAs as part of their regular program. Only 6 projects are funded from the Interational Office; there will be fewer in the future.