Global Health in Transition: A Synthesis Perspectives from International Organizations (1996) / Chapter Skim
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I: The Documents Reviewed: An Analysis--Disease Control Priorities in Developing Countries
I: The Documents Reviewed: An Analysis--Disease Control Priorities in Developing Countries
Pages 7-13
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I The Documents Reviewed: An Analysis
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Its impetus was recognition of the lack of analytic approaches developing countries might take in dealing with the implications of the health transition and the emergence of behavioral risk factors and noncommunicable diseases as significant problems. Each chapter assesses the current and probable future public health significance of over 100 individual diseases or related clusters of diseases in the developing world.
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Although core sets of preventive and clinical interventions would seem appropriate to the needs of most countries, they will have to be defined and targeted to account for local epidemiologic variability and financial capacities. • Primary prevention or public health interventions are not inherently more cost-effective than the clinical strategies that are suggested, none of which requires more specialized facilities than those available at a reasonably well-equipped, well-organized district hospital.
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Improve health services delivery by -- continuing emphasis on immunization and family planning and increasing selectivity in delivery of oral rehydration therapy and tuberculosis vaccine (BCG) in low-risk environments; -- enhancing emphasis on measles immunization, case management of acute respiratory infection, control of vitamin A deficiency, tuberculosis chemotherapy, anti-helminthic prophylaxis, control of sexually transmitted diseases, and control of cancer pain; -- strengthening capacity for drug logistics to support system priorities, provider training to manage priority procedures, and delivery of inexpensive rehabilitative services; and -- reducing support for hospital facilities and shifting emphasis away from general institutional development and toward strengthening specific capacities.
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3. Increase allocation of resources to research for -- exemplary programs of essential national health research; -- epidemiologic and operational research on cardiovascular and other noncommunicable diseases, sexually transmitted diseases, mental and chronic obstructive pulmonary disorders, and injury; -- assessment of intervention cost-effectiveness in different environments; -- vaccine development; -- strengthening national and international capacities to address these research emphases; and -- monitoring epidemiologic trends and the efficacy of intervention in well-documented populations.
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Modeling remains important, but in a context in which each country is helped to build capacity to assess its own needs, reform its own policies, and adapt models to its own situation. Thus, the new capacities required to advance health would build on the methods and strategies presented in this volume and would include construction of health care prototypes at the district level to handle changing epidemiology, relevant health research, human resources development, and related policy making and implementation.
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