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Child survival and development toward Health for All: roles and strategies for Asia-Pacific universities.
ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH. 1989; 3(2):118-28.The child survival and development movement in relation to universities in the Asia-Pacific region were the subject of recent discussions of medical practitioners and academics. There are 14 million deaths of children that could be avoided if they could benefit from immunizations, pure water, sanitation, nutrition, and oral rehydration therapy. Also there is a large loss of physical and mental ability. Many international agencies have helped improved children's health and survival, and life expectancy has risen 40% in the last 40 years. In countries such as China, India, Pakistan, Thailand, and Indonesia there has been an exceptional achievement in child survival and development. In many developing countries health services have been patterned after western medical systems that promote treatment rather than prevention. Universities' role in relation to these problems has been the conducting of research, providing instruction, education, and training. The areas of success are in vaccine development and mass communications research. New roles can be taken in technical assistance and introduction of technology in planning and evaluation. There are also possibilities in the pooling of information and resources to help in child survival and development. In long range strategies and roles, universities can use conventional methods. In midrange areas the universities can use new modes and share and interact with governments and international organizations. In the short term they can use the less conventional methods and follow the leadership of the international organizations. In short term, universities can provide help in planning of national campaigns, provide resources, and participate in evaluations of campaigns. In the mid-range they can be involved in joint initiatives in operations research, specialized training, and clinical trials. In the long range universities are best suited to conventional research, training, laboratory science and technology development.
ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH. 1989; 3(2):98-104.One of the most pressing problems in the health system is the lag between modern knowledge and its use in the community. This is caused by the inadequate scientific study of methods to apply this knowledge to society, and the poor training of health personnel to apply these methods. These failures are illustrated every day by the death of 50,000 people, mostly children under 5 years, from causes that are preventable at low costs. The medical education system is primarily responsible for what is taught and how it is taught, and yet less than 1% of the this education is related to community health and broad health education. Social organization is the key to efficiency of health protection and use of medical knowledge. The mass media and increasing communications development with modern marketing have allowed social organization at reasonable cost. Changes in human behavior can prevent most health problems and premature deaths. There are examples of how growth monitoring, oral rehydration therapy, breast feeding promotion, immunization, family planning, and female literacy have saved millions of children. There is now a global recognition that healthy children and healthy families are the foundation for national development. International goals are to reduce mortality rates for children under 5 to 70/1000, eliminate polio, have universal primary education, have less than 1% malnutrition, and promote water supply expansion and sanitation. There is also a need for better recordings of births and deaths and, especially in developing countries, low cost methods of collecting data are needed. Medical education needs to use the full range of resources, and students need to learn to promote health as well as treat diseases. Medical schools in consideration of primary health care must revise curricula to achieve a balanced education in the community, and students should be taught in a variety of environments from rural health areas to urban institutions.