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Assessment and implementation of health care priorities in developing countries: incompatible paradigms and competing social systems.
Social Science and Medicine. 1984; 19(4):373-84.This paper addresses conceptual issues underlying the assessment and implementation of health care priorities in developing countries as practiced by foreign development agencies coping with a potentially destabilizing unmet social demand. As such, these agencies mediate the gap between existing health care structures patterned around the narrow needs of the ruling classes and the magnitude of public ill-health which mass movements strive to eradicate with implications for capitalism at large. It is in this context that foreign agencies are shown to intervene for the reassessment and implementation of health care priorities in developing countires with the objective of defending capitalism against the delegitimizing effects of its own development, specifically the persistence of mass disease. Constrained by this objective, the interpretations they offer of the miserable state of health prevailing in developing countries and how it could be improved remains ideological: it ranges between "stage theory" and modern consumption-production Malthusiansim. Developing countries are entering into a new pattern of public health which derives from their unique location in the development of capitalism, more specifically in the new international division of labor. Their present position affects not only the pattern and magnitude of disease formation but also the effective alleviation of mass disease without an alteration in the mode of production itself. In the context of underdevelopment, increased productivity is at the necessary cost of public health. Public health improvement is basically incompatible with production-consumption Malthusianism from which the leading "Basic Needs" orientation in the assessment and implementation of health care priorities derives. Marx said that "countries of developing capitalism suffer not only from its development but also from its underdevelopment." (author's modified)
[Unpublished] 1984. v, 25 p.This meeting was sponsored by the World Health Organization (WHO) with Dr. Wayne S. Stinson participating at WHOs request. The objectives of the informal consultation were: 1) to strengthen national capabilities for undertaking the costing of preimary health care and for the utilization of results for development and management; 2) to exchange experiences on the costing of PHC in different countries; 3) to discuss methodologies used for data collection at the PHC center; and 4) to make recommendations for future work. This consultation is one in a series of costing and financing meetings held by WHO since 1970. The most recent meeting prior to 1983 was an interregional workshop on the cost and financing of primary health care, held in Geneva in December 1980. Papers distributed at that meeting (which have not yet been published) suggest a need for greater understanding of costing principles and technical refinement of methodologies. Judging by the papers presented at the Nazareth workshop, costing efforts have greatly improved since 1980. Representatives from the following countries participated in the Nazareth workshop: Argentina, Botswana, Columbia, Thiopia, Gambia, Kenya, Lesotho, Malawi, Sierra Leone, Sri Lanka, Swaziland, Tanzania, Thailand, Uganda, and Zambia. Some of these reported costing studies. This report consists of a narrative description of the meeting itself followed by a commentary on some of the issues raised. There is then a discussion of Arssi Province and Ethiopia as a whole based on a 1-day field trip. Finally recommendations are given regarding the United States Agency for International Development's (AID's) further PHC costing efforts.
Freetown, Sierra Leone, Ministry of Education, 1984. 80 p. (UNFPA/UNESCO Project SIL/76/POI)The National Programme in Social Studies in Sierra Leone has created this text in social studies, with an emphasis on population education, for 2ndary school students. Unit 1, "Man's Origins, Development and Characteristics," covers traditional, religious and scientific explanations of man's origin; man's characteristics and the effects of these characteristics; and the beginnings of population growth and the characteristics of human population. In Unit 2, "Man's Environment," the word environment is defined and geographical concepts are introduced. Unit 3, "Man's Culture," defines institution and discusses family types, roles and cycles, as well as traditional ceremonies and cultural beliefs about family size. Unit 4, "Population and Resources," primarily deals with how the family meets its needs for food, shelter and clothing. It also covers the effects of population growth. Unit 5, "Communication in the Service of Man," discusses the means and growth of communication and collecting vital information about the population. The last unit defines global issues and discusses the interdependence of nations, issues affecting nations at the individual and world level, and the UN.
Freetown, Sierra Leone, Ministry of Education, 1984. 80 p. (UNFPA/UNESCO Project SIL/76/POI)The National Programme in Social Studies in Sierra Leone has created this textbook in the social sciences for secondary school students. Unit 1, "Man's Origins, Development and Characteristics," presents the findings of archaeologists and anthropologists about the different periods of man's development. Man's mental development and population growth are also considered. Unit 2, "Man's Environment," discusses the physical and social environments of Sierra Leone, putting emphasis on the history of migrations into Sierra Leone and the effects of migration on population growth. Unit 3, "Man's Culture," deals with cultural traits related to marriage and family structure, different religions of the world, and traditional beliefs and population issues. Unit 4, "Population and Resources," covers population distribution and density and the effects of migration on resources. The unit also discusses land as a resource and the effects of the land tenure system, as well as farming systems, family size and the role of women in farming communities. Unit 5, "Communication in the Service of Man", focuses on modern means of communication, especially mass media. Unit 6, "Global Issues: Achievements and Problems," discusses the identification of global issues, such as colonialism, the refugee problem, urbanization, and the population problems of towns and cities. The unit describes 4 organizations that have been formed in response to problems such as these: the UN, the Red Cross, the International Labor Organization, and the Co-operative for American Relief.
Freetown, Sierra Leone, Ministry of Education, 1984. 93 p. (UNFPA/UNESCO Project SIL/76/POI)The National Programme in Social Studies in Sierra Leone has created this textbook in the social sciences, with an emphasis on population education, for 2ndary school students. Unit 1, "Man's Origin, Development and Characteristics," describes Darwin's theory of evolution and explains how overproduction causes problems of rapid population growth and poor quality of life. Special attention is given to the problem of high infant mortality in Sierra Leone. Unit 2, "Man's Environment," discusses the interrelationships and interdependence among elements in the ecosystem, the food pyramid, and the effects of man's activities and numbers on the ecosystem. Unit 3, "Man's Culture," focuses on the processes of socialization and the different agents of socialization: the family, the group, the school, and the community. Unit 4, "Population and Resources," discusses human and natural resources as well as conservation measures. It also discusses the population composition, its effect on resources, and the uses and significance of population data. Unit 5, "Communication in the Service of Man," covers land, water and air transport; the effects of transport developments in Sierra Leone; and implications for population of changes in transport activities. Unit 6, "Global Issues: Achievements and Problems," deals with the young population, characteristics of the adolescent, common social problems among young people, and the role of the family unit. National and international action is also discussed.