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Appropriate technology for health (ATH): a directory of organizations, institutions groups, and individuals.
Geneva, WHO, 1980 Aug. 199 p. (ATH/80.2)This directory contains a listing of organizations, institutions, groups and individuals involved in the development of health and health-related appropriate technology. It contains 418 entries from 83 countries, with a separate listing for international organizations. Country codes and subject index are provided. Where information is available, a short summary of objectives and activities of the institution is presented.
[Washington, D.C.], U.S. Agency for International Development, 1980 May. 19 p. (A.I.D. Project Impact Evaluation Report No. 5)Since 1970, the Government of Kenya has been involved in a program to bring water to all its population. Although the investment has been high, the results have been disappointing. The government is still committed to the long term goal of universal supply, but recognizes that competing demands may now require a review of the long term objectives for water development. The lessons learned from past efforts are important for AID as it assists water supply projects in other countries. Kenya's national rural water program differs from that in most other countries in the size of the project and method of supplying water. The typical Kenyan water system is large. The aim of most systems is to supply water to individual families through metered private connections; because Kenyan communities are dispersed, long distribution lines are used. These complex systems are impeded by problems of design, construction and maintenance, making them unreliable. Maintenance problems are mainly due to low government funding levels. The government discourages the use of communal facilities by locating them inconveniently. AID has provided funding to self-help systems through CARE-Kenya. Recommendations include: insuring adequate funding for operation of systems, selecting technology from the full range of options available, and involving the community in the process of providing supplies. System reliability should be a primary concern. Rural water projects require varying amounts of institutional support based on the technology used.
A systematic approach to planning the appropriate technology for primary child care: a necessary step toward realizing Alma-Ata.
In: American University of Beirut. Faculty of Health Sciences. Human resources for primary health care in the Middle East. Beirut, Lebanon, American University of Beirut, 1980. 128-39.Focusing on the essential technologies for the clinical aspect of primary health care (PHC), this discussion argues that it is possible to define them. If PHC is ever to achieve an acceptable standard, these technologies must be available in the languages of all the world's health workers in a systematic form. This objective is both concrete and practicable. A great need exists for appropriate knowledge, and there is an even greater "application gap" in which technologies of proven value are not even known to the people who might use them. There are 2 essential preliminary steps, both of which are largely attainable: to organize the technologies systematically in at least 1 language and to keep the system currently under review so that it is always up to date; and to keep a careful watch on what is available in the languages of the world's health workers and to try to fill as many as possible of the gaps, either by encouraging original writing or by translation. With minor exceptions, the essential technologies for PHC are universally applicable. About 90% of the technologies for primary care are applicable everywhere. PHC is so complex that 2 initial simplifications are required: the level of the worker to be addressed; and to isolate appropriate technology, which is mostly applicable worldwide, from matters of culture and administration, which are highly specific locally. The ultimate objective is for an appropriate technology to be adopted and applied to heal the sick. Technologies can be promoted in at least 6 ways: the appropriate technology must be carefully and completely described step by step; the description of the appropriate technology must be accompanied by sufficient theory to make the necessary action seem reasonable to the workers; the necessary equipment must appear in a government medical store's list and in the UN International Children's Emergency Fund (UNICEF) list; the technology must be accompanied by the necessary evaluation procedures; a group of technologies must be accompanied by its appropriate management targets; and the appropriate technologies must be accompanied by the necessary teaching aids. There are important links between technologies; they mutually support each other. Not only does 1 technology support another, but the various different ways of promoting the same technology support one another. Currently, the emphasis is rightly on providing everyone with access to at least some health care, but the need to measure and increase the quality of that care is already being felt. It is a formidable task to plan these detailed systems of technologies for primary care. The World Health Organization (WHO) could do it by mobilizing the necessary talent globally. Also, WHO, assisted by the bilateral agencies, has the power to define the essential technologies for PHC, to systematize them anonymously, and to encourage its member states to make sure they are available in the languages of all the world's health workers.
Brazzaville, Congo, World Health Organization, Regional Office for Africa, 1980. 86 p. (Health Development in Africa 1)Primary health care has been accepted by the 44 Member States and Territories of the African Region of the World Health Organization (WHO); the Health Charter for 1975-2000 was adopted in 1974 with its humanistic approach oriented to satisfying basic needs. Genuine technical cooperation between Member States is essential for health development and can be achieved on the regional level. By 1990 the following steps should be taken: 1) vaccination of all infants under 1 year against measles, pertussis, tetanus, poliomyelitis, diphtheria and tuberculosis, 2) supply of drinking water to all communities and 3) waging a war on hunger. Health development is seen as a social development policy requiring combined efforts in the fields of education, agriculture, transport, planning, economics, and finance as well as a national strategy which WHO can help to define. A new international economic order must aim at meeting basic needs of the poorest in the population and includes health needs. Basic health services must provide primary health care which includes preventive and curative care, promotional and rehabilitative care, maternal and child health, sanitation, health education, and systematic immunization. Secondary care includes outpatient services with specialized teams; tertiary care provides highly specialized services. These services must be geographically, financially, and culturally accessible to the community. Communication between health workers and community leaders is fundamental in setting up those services and group dynamics can be utilized in promoting change. WHO's 4 health priorities in Africa are: 1) epidemiological surveillance, 2) promotion of environmental health, 3) integrated development of health manpower and services, and 4) health development research promotion. The components of Africa's health care program are: 1) community education, 2) promotion of food supply and nutrition, 3) safe water and sanitation, 4) maternal and child health, 5) immunization, 6) disease prevention, 7) treatment of injuries and diseases and 8) provision of essential drugs. Proper training of personnel is crucial for the success of these steps, along with effective personnel management.
Alexandria, World Health Organization (WHO), Regional Office for the Eastern Mediterranean, 1980. 133 p.An assessment of health progress in the Eastern Mediterranean Region (EMR) is provided through narration and photographs. The renewed threat of malaria and efforts to control it are discussed. Other traditional diseases of the area examined in today's terms are schistosomiasis, cholera, tuberculosis, trachoma and smallpox. Modern health problems, including cancer, heart diseases, mental disorders and occupational hazards are explored. Environmental problems, or "the fall-outs of technology," are discussed, along with urban sprawl, water shortages, air and marine pollution and desertification. It is stressed that changing times demand changing attitudes towards the environment. Specific areas that need to be addressed, particularly food safety, are pointed out. WHO's work with EMR countries in health manpower development includes planning, educational development and support, and the actual training of individuals. The need for more health personnel is documented. Nursing as a profession in the EMR is discussed, as is its growth; 1 problem in education of nurses is the lack of textbooks in Arabic. The prospects of health for all by the year 2000 are discussed. The importance of using appropriate technology in providing primary health care is stressed. Family health and planning is examined, including child care priorities such as newborn care, the critical weaning period, and immunization. Current biomedical research in the EMR is discussed, including health services research, efforts for diarrhea and streptococcal infection control, drug utilization studies, tropical disease studies and the search for a malaria vaccine. MEDLINE, the regional health literature service, is described. Technical cooperation among the countries of the EMR is discussed. Profiles showing the population, medical manpower and health facilities of each country in the EMR are provided.
Seattle, Washington, Program for the Introduction and Adaptation of Contraceptive Technology [PIACT], . 2 p.PATH (the Program for Appropriate Technology in Health) was formed in 1979 as the health division of PIACT (Program for the Introduction and Adaptation of Contraceptive Technology). PATH aims at linking government and private agencies providing health services in developing nations with the manufacturers and developers of health-related technology. PATH also seeks to identify and support technologies which will contribute significantly to existing health care delivery systems in developing countries. Examples of PATH-sponsored projects are: 1) the development of a time-temperature marker to monitor the continued efficacy of measles vaccine stored at less than optimal temperatures; 2) a nonverbal instructional pamphlet to teach the correct preparation of ORS (oral rehydration salts); 3) development of an alternative formulation of ORS; and 4) adaptation of the packaging and labeling of ORS to local cultural conditions. PATH would like to evaluate and maintain the new technology, once developed and introduced.
SCIENCE. 1980 Jul 4; 209(4452):157-64.In order to combat the growing food problem in developing countries, efforts must be directed toward 1) increasing food production through agricultural intensification and through improving transportation, water, storage, communication, banking, and processing systems; 2) increasing the purchasing power of the poor; and 3) slowing down population growth. Science and technology can play a significant role in increasing food production and generating rural income. Agricultural technology cannot be transfered directly from the developed nations, located primarily in temperature zones, to the developing countries, located primarily in tropical and sub-tropical zones. A 3 tiered research system aimed at developing appropriate agricultural techniques and crops for developing countries is evolving. The 1st tier consists of small, national research centers, located in the developing countries. These centers conduct applied research aimed at determining which seed varieties, fertilizers, disease and pest control methods, and cropping methods are most appropriate for their own farm areas. The 2nd tier consists of a number of international or regional research institutes, located in developing countries and directed toward solving specific regional problems. For example, the International Rice Research Institute in the Philippines conducts research aimed at improving rice yields and trains people to use these techniques while the Center for Agricultural Research in Dry Areas, located in Lebanon and Syria, seeks to develop seeds and cropping systems tailored for use in dry regions. In 1969 a number of these institutes recognized that a united effort would be advantageous, and the CGIAR (Consultative Group on International Agricultural Research) was established. CGIAR, sponsored by the World Bank, the United Nations Development Programme, and the Food and Agriculture Organization, supports the work of these institutes and helps develop new institutes. At the present time the CGIAR supports 13 centers and has an operating budget of $120 million. The CGIAR advisory committee, composed of 13 agricultural experts, sets global priorities and monitors the work of the institutes. The 3rd tier in the research system consists of institutes, which are located in developed countries and which engage primarily in basic agricultural research. In the future, greater efforts should be made to 1) increase private sector participation; 2) strengthen the links between the research levels; and 3) encourage political leaders to commit themselves to solving the hunger problem.
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.