Showing papers on "International health published in 1975"

Health by the people.

Abstract: Abstract A stimulating analysis, based on country studies, of innovative methods of delivering primary health care to populations, particularly in rural areas. The book has ten chapters. The first describes the approach taken in India to integrating a traditional system of medicine, the Ayurveda system, into the health services as a whole. The remaining chapters fall into three groups. Chapters in the first group consider experiences in countries characterized by far-reaching changes at the national level, as in China, Cuba, and Tanzania. The second group, which includes Iran, Niger, and Venezuela, shows how changes have been made through an extension of the existing system. The final group is characterized by community development in limited local areas of Guatemala, India, and Indonesia

Teamwork in health care in the U.S.: a sociological perspective.

Abstract: Reactions to team work whether in health care, science and research, or in other areas are seldom neutral. While some see in it a panacea that will help solve many stubborn organizational problems, others condemn it on a variety of grounds. To borrow Homan’s expression, it seems that team approaches are viewed as matters of morals rather than matters of strategy. In spite of those strong attitudes, or perhaps because of them, literature on this topic remains more descriptive and prescriptive than analytical. The attempt in this paper will be to clarify the place of team work in health care, to review the thrusts of current studies and the important findings, and to point out some neglected dimensions that warrant research attention.

Health and public policy.

Abstract: Complaints are frequent that the United States lacks a national health policy. What that allega? tion means is rarely made clear. Policy means different things to different people. But, if by policy one means legislative and governmental administrative actions, it is conspicuous that this nation has been spawning health policies at a proliferating and bewildering rate ever since World War II. Keeping up with the multiplicity of policies has become a formidable challenge, and few succeed.

Meeting basic health needs in Tanzania.

Abstract: The overall objective of current health care policy in Tanzania is better coverage of the population The 1967 Arusha Declaration which defined Tanzanias social and economic policy for the current period directed that rural areas should receive priority in all development programs Thus the development of health services has been incorporated into overall rural development Tanzania is among the 25 least developed of developing countries The scarcity of economic resources has impeded progress in the health sector However the impact of meager resources has been somewhat offset through an emphasis on disease prevention widespread health education use of auxiliary personnel and community involvement and self-help Rural health care is provided by rural medical aides maternal and child health aides health auxiliaries and medical assistants who work under the supervision of the next tier of the health service The countrys basic health units are the district hospitals rural health centers and dispensaries There were 1555 dispensaries in 1974 with a district/population ratio of 1:9000 100 new dispensaries will be built each year to raise this ratio to 1:6000-8000 by 1980 The 108 health centers existing in 1974 led to a 1:99750 center/population ratio 25 new centers will be constructed yearly to reach the target ratio of 1:50000 by 1980 There are 123 hospitals 60 of which are voluntary Growth of the hospital sector is not a priority The number of beds will be increased by 3% annually to keep up with population growth Tanzania hopes to collaborate with other countries on health services to maximize the impact of meager economic resources and avoid costly duplication of services The Tanzanian example shows that better population coverage can be attained under conditions of underdevelopment through good planning good leadership and self-reliance

Community Health, Preventive Medicine, and Social Services

Abstract: Provides a comprehensive guide to community and social services in the UK, highlighting the central role of preventive medicine in primary health care Topics new to this edition include: AIDS; sexually transmitted diseases and viral hepatitis; drugs and alcohol abuse; and child abuse

On Paying the Fiddler to Change the Tune: Further Evidence from Ontario regarding the Impact of Universal Health Insurance on the Organization and Patterns of Medical Practice

Abstract: This paper compares the findings from a 1973 community household interview survey conducted in Sault Ste. Marie, Ontario, with the findings from a similar study conducted in 1968 in the same city by a research team from the World Health Organization. Sault Ste. Marie is the site of the first Canadian consumer-sponsored prepaid group practice. Opposition by the private, solo practice sector of this community to this new modality of medical practice was considerable. Since 1969, with the introduction of universal health insurance in Ontario, the cost and benefit differences between solo and group practice medical care have been eliminated. By comparing the findings from the 1973 study with similar data from the 1968 WHO survey, observations can be made about the impact of universal health insurance on the organization and patterns of medical practice. Implications for the United States are important in view of the recent passage of the Health Maintenance Organization Act of 1973 and the expected enactment of some form of national health insurance.

Research in health economics: a survey.

Abstract: This paper surveys the types of issues with which health economists have been concerned. It is intended to introduce noneconomists to the kinds of questions that economists have regarded as important. Economists' work in the health economics area may be usefully divided into "positive" and "normative" studies. Positive studies are those designed to describe, or make predictions about, how the health care system, or parts of it, actually operate. Conversely, normative studies are intended to provide statements as to how the health care system should operate. The major areas surveyed include the concept and estimation of the "production function" for health, the distinction between private and social costs, determinants of prices of medical inputs, and benefit-cost analysis.

The political context of health service regulation.

Abstract: Can regulation work in health services, given the present political context? General issues in the regulatory process are discussed, followed by a consideration of the relevance of these issues to the health care field. Regulatory processes are reviewed for the United States in four areas: credentialling of people, surveillance of delivery systems, quality of materials and technology, and rate-setting or cost control. It is concluded that the process cannot work. Four alternatives are presented and briefly evaluated: tinkering, centralized regulation, national health service, and general nationalization of most major economic sectors.

Administration in mental health: issues, problems, and prospects.

Abstract: The mental health field has grown larger and more complex in recent years, but this has not been equalled by increased administrative sophistication. Two problems, neither one irremediable, have contributed to this state of affairs. First, mental health organizations have generally been administered by mental health professionals with little administrative knowledge or training. And second, we have often failed to recognize the very special circumstances faced by administrators in the mental health field. These special circumstances are legion. For one thing, mental health services depend on public funding and must often deal with a high degree of government regulation. For another, the typical staff in a mental health organization is multidisciplinary, professional, and highly autonomous-a bit like a Navy with more admirals than ships. Then too, the transaction between therapist and patient is much more private and intimate in mental health than in most other fields; we are often dealing with a highly dependent patient population; our product is intangible and the success achieved is hard to judge; the boundaries of the field are very hard to define; and the enduring public stigma associated with use of mental health services, combined with the problem of confidentiality, complicates the administrative task. Finally, on top of all this, it is absolutely essential that the mental health administrator understand the need to create and maintain an organizational climate of efficacy and hope. Taken individually, many of these conditions have obvious counterparts in other fields; but taken as a group, they separate mental health from all the other human services, even ones that are closely related. To be effective, therefore, academic programs in mental health administration must reflect these conditions by developing specialized curricula and training procedures.

Health care of mothers and children in national health services: Implication for the United States

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Health care in a changing society: the health services of Israel.

Abstract: In the pre-State era, Israeli society displayed an "ascetic" orientation with emphasis on austerity and egalitarianism. The medical profession was influenced by the basic philosophy of the country and coped successfully with the country's health problems, mainly by lowering morbidity and mortality rates. With the emergence of the State of Israel, mass immigration of people with different backgrounds, cultures, and values occurred, and health problems of the disability, dissatisfaction, and discomfort type arose. The existing medical organizations were unable to handle them. The story of three such organizations is detailed in brief: the first medical school in Jerusalem, the greatest supplier of curative services--the workers' sick fund (Kupa Holim), and the Ministry of Health. Their impact on the health services of the country is described. These services are splintered into numerous self-contained authorities and an understanding of the overall needs is lacking. This state of affairs reflects the antagonistic interests of the political powers behind the various health agencies. A concensus within the health field on the nature of the problems and their solution could be reached if the health organizations accepted a broader philosophy of health, comprising its somatic, mental, and social aspects, and if they commit themselves to applying this philosophy in their activities. This may lead to considerable changes in medical education, more attention being focused on the social functions of medicine than on medical technology; health care would become more comprehensive and would cover all aspects of health in its preventive, curative, and rehabilitative stages. Failure to meet the health needs of the changing society will constitute a false reading of the public pulse. Of late, the voices demanding the conquest of social diseases and the attainment of health in its broadest sense are becoming more and more audible.

Mental Health Organizations in Transition

Abstract: Many mental health institutions are changing their traditional treatment policies and practices and their organizational structures. Literature is reviewed which provides a model for changing mental health organizations based in general systems theory. The systems organizational model has empirical support in the growing community mental health movement. The strong interaction of technological and ideological factors determining the nature of the new mental health organizations is stressed. Also considered are some of the problems facing those planning and managing changing mental health organizations.