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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)
China: long-term development issues and options. The report of a mission sent to China by the World Bank.
Baltimore, Maryland, Johns Hopkins University Press, 1985. xiii, 183 p. (World Bank Country Economic Report)This report summarizes the conclusions of a World Bank study undertaken in 1984 to identify the key development issues China is expected to face in the next 20 years. Among the areas addressed by chapters in this monograph are agricultural prospects, energy development, spatial issues, international economic strategy, managing industrial technology, human development, mobilizing financial resources, and development management. China's economic prospects are viewed as dependinding upon success in mobilizing and effectively using all available resources, especially people. This in turn will depend on sucess in reforming the system of economic management, including progress in 3 areas: 1) greater use of market regulation to stimulate innovation and efficiency; 2) stronger planning, combining indirect with direct economic control; and 3) modification and extension of social institutions and policies to maintain the fairness in distribution that is basic to socialism in the face of the greater inequality and instability that may result from market regulation and indirect controls. Over the next 2 decades, China can be expected to become a middle-income country. The government has set the goal of quadrupling the gross value of industrial and agricultural output between 1980 and 2000 and increasing per capita income from US$300 to $800. China's size and past emphasis on local self-sufficiency offer opportunities for enormous economic gains through increased specialization and trade among localities. Increased rural-urban migration seems probable and desirable, although an increase in urban services and infrastructure will be required. The expected slow rate of population increase is an important foundation for China's favorable economic growth prospects. On the other hand, it may not be desirable to hold fertility below the replacement level for very long, given the effects this would have on the population's age structure. The increase in the proportion of elderly people will be a serious social issue in the next century, and reforms of the social security system need to be considered.
BACKGROUND NOTES. 1985 Oct; 1-8.Yugoslavia was formed on December 1, 1918 from the kingdoms of Serbia and Montenegro plus parts of the Turkish and Austro-Hungarian Empire. Its population has the greatest ethnic and religious deversity of any in Eastern Europe. The main language is Serbo-Croatian. Yugoslavia has worked hard to maintain its independence despite pressure from the international Communist organization Cominform. Since the 1960s they have been identified as a leader of nonaligned nations. 6 republics comprise the Socialist Federal Republic of Yugoslavia and each of these republics has its own government modeled on the federal structure. The federal government has executive, legislative, and judicial branches. The Constitutional Court rules on the constitutionality of all laws and regulations. The League of Communists is the only political party allowed to function; however, it does permit open expression of differences on some major policy issues. Since the end of World War 2, the Yugoslav economy has become an industrialized, midlevel technological economy and the standard of living has risen. Yugoslavia has tried to maintain a rough balance in trade relations with Western nations, with the socialist bloc, and with the developing world. Agricultural production has risen steadily over the years but its full poteential has not yet been realized. Yugoslavia has tried to establish friendly relations with most states, especially in Western Europe. The US has made an effort to support Yugoslavia in its attempt to maintain independence and through cultural, commercial, and political involvement has attempted to offer alternatives to being dependent on the Soviet Union. Relations have been further strengthened by continuing high-level visits by heads of state. While there are differences of view on many foreign policy issues, the US has respected Yugoslavia's position and has offered continued support.
WORLD OF WORK. 1996 Sep-Oct; (17):10-1.Viet Nam's shift toward a market-oriented economy has been associated with annual gross domestic product growth of more than 8% over the past 5 years. At the same time, the emergence of private-sector enterprises and subsequent closure of many state-run enterprises have had profound implications for Viet Nam's social protection systems. At present, only 5.6 million of the country's 33 million workers are covered under the state-run social insurance system. In 1995, the government moved to include private enterprises with 10 or more employees in its state benefits system. The International Labor Organization (ILO) has been working with the Vietnamese Government to design and implement a social security system that would extend coverage progressively to excluded sectors and provide support to workers who have become unemployed as a result of the economic transition process. At its Eighth National Congress, the Vietnamese Communist Party approved a 5-year social and economic plan calling for such an expansion of the social insurance system as well as for a guaranteed standard of living for pensioners. To facilitate anticipated changes, activities that were previously divided between the Ministry of Labor, Invalids, and Social Affairs and the Vietnam General Confederation of Labor have been assigned to the newly formed Vietnam Social Insurance (VSI) Organization. Under consideration is a plan to combine some VSI activities with those of the Vietnam Health Insurance Organization. The ILO will assist with training, computerization, and social security fund investing. Noncompliance is a major obstacle to planned expansion of the social security system; about 90% of private firms are still not paying into the system.
Geneva, Switzerland, UNRISD, 1991. , 61 p.Progress in implementing the research program and related activities of the UN Research Institute for Social Development (UNRISD) between July 1990 through June 1991 is described. An autonomous institution within the UN, UNRISD seeks to promote research on pressing problems and contemporary social issues associated with development. UNRISD Director Dharam Ghai explains that the Institute takes a holistic, interdisciplinary, and political economy approach in its research programs. Some of the highlights of 1990-91 are described, as well as UNRISD's progress in 8 general areas of research. The first category of research is that of 1) environment, sustainable development and social change, and area that includes the following subtopics: resource management, deforestation, women and their environment, and the socioeconomic dimensions of environment and sustainable development. The remaining general categories include: 2) crisis, adjustment, and social change; 3) participation and changes in property relations in communist and postcommunist societies; 4) ethnic conflict and development; and 5) political violence and social movements; 6) refugees, returnees, and local society: interaction and development; 7) socioeconomic and political impact of production, trade, and use of illicit narcotic drugs; and 8) patterns of consumption: qualitative indicators of development. A list of all publications during the year is included as well as a list of all board and staff members.