RESUMEN
The curriculum in community health is best described as eclectic and dynamic. Its relevance is maintained by its response to the macro-environment; this response, whether innovative or otherwise, may be incremental on the one hand or feature wholesale change consequent on radical rethinking on the other. This paper reviews the content of the emerging curriculum in community health at the University of the West Indies, Jamaica, and attempts to discern the process of change and the factors which have informed these developments.
Asunto(s)
Humanos , Historia del Siglo XX , Curriculum/tendencias , Medicina Comunitaria/educación , Atención Primaria de Salud , Facultades de Medicina , Prácticas Clínicas , Jamaica , Medicina Comunitaria/historia , Medicina Comunitaria/tendencias , Medicina Preventiva/educación , Medicina Social/educación , Salud RuralRESUMEN
The prevalence of health insurance in a low-income Jamaican community was determined from a systematic sample of 103 households. A household prevalence for health insurance of 32 pro cent was found. Differentials in health service utilisation were more striking for private preactitoner services where the highest correlations with coverage was found (r=0.346, p < 0.001). A negative correlation (r=-036, N.S. with local health centre utilisaion was obtained. For every 100 people attending a private facility, 33 had health insurance coverage. The level of health insurance coverage in the community and its impact on service utilisation would suggest the possibility of harsh economies in the health sector, forcing consumers in low-income groups to seek a buffer for the expenses incurred from needs unmet by the public services. Part of this favourable prevalence of health insurance may also be due to job-related coverage