ABSTRACT
In the Americas, health sector reforms are facing the challenge of strengthening the steering and leadership role of health authorities. An important part of that role consists of fulfilling the essential public health functions (EPHFs) that are incumbent on all levels of government. For that, it's crucial to improve public health practice, as well as the instruments used to assess the current state of public health practice and the areas where it needs to be strengthened. For that purpose, the Pan American Health Organization has started an initiative called "Public Health in the Americas," with the objective of defining and measuring EPHFs, as a way of improving public health practice and strengthening the leadership provided by health authorities at all levels of government. This article summarizes conceptual and methodological aspects of defining and measuring EPHFs. The article also analyzes the implications that measuring performance on these public health roles, responsibilities, and activities would have for improving public health practice in the Americas.
Subject(s)
Health Care Reform/organization & administration , Public Health/methods , Americas , World Health OrganizationSubject(s)
Health Promotion , Social Problems , Violence , Humans , Pan American Health OrganizationABSTRACT
This article discusses the epidemiologic and programmatic bases for action as well as the political, historical and technical background for "The Initiative for Restructuring of Psychiatric Care in Latin America." It discusses also the broad implications of this health policy, the modus operandi of its implementation and monitoring, and the chief obstacles that it has encountered. Lastly, it briefly sketches the results obtained thus far.
Subject(s)
Health Policy , Mental Disorders/therapy , Mental Health Services/organization & administration , Mental Health Services/trends , Female , Humans , Latin America/epidemiology , Male , Mental Disorders/epidemiology , Pan American Health Organization , PrevalenceABSTRACT
Both the epidemiological and program bases for action are reviewed as well as the political, historical, and technical background of the Initiative for a Re-structuration Psychiatric Care in Latin America. Attention is also paid to (a) the wide repercussion of this new-old health policy, (b) procedures for its implementation, and (c) the main obstacles the Initiative has been facing to date. Results obtained so far are reviewed.
Subject(s)
Mental Health Services/organization & administration , Regional Medical Programs/organization & administration , Latin America , Pan American Health OrganizationABSTRACT
Both the epidemiological and program bases for action are reviewed as well as the political, historical, and technical background of the Initiative for a Re-structuration Psychiatric Care in Latin America. Attention is also paid to (a) the wide repercussion of this new-old health policy, (b) procedures for its implementation, and (c) the main obstacles the Initiative has been facing to date. Results obtained so far are reviewed.
ABSTRACT
A case is made that a new frontier of international health is developing technical cooperation among countries of the Americas for narrowing and eventually filling the gap between them. Several initiatives of PAHO are cited.
Subject(s)
Forecasting , Global Health , Health Planning Technical Assistance , Pan American Health Organization/organization & administration , Americas , Diffusion of Innovation , International Cooperation , Organizational Objectives , Regional Medical ProgramsABSTRACT
PIP: Approximately 700,000 infants die annually in the Americas from causes that could be prevented by low-cost interventions and technologies. The main determinants of infant mortality in the Americas are the socioeconomic status of the family, environmental factors, and some specific maternal and child health problems. Progress in reducing infant mortality has varied widely among the countries. From 1960-1985, the infant mortality rate declined 21% in Bolivia, while it decreased 64% in Costa Rica, but even in the most recent 5-year period, Bolivia and Haiti still had infant mortality rates above 100/1000. Unfortunately, an increase in the gross national product does not automatically translate into greater expenditures on health; conversely, significant improvements in health can be achieved in the absence of high levels of economic progress. Parental education, especially the mother's, is 1 of the most important factors affecting infant mortality. Regrettably, per capita public spending on education declined between 1980 and 1984 in Latin America and the Caribbean. The sizable migrations, both voluntary and involuntary, have contributed to infant mortality. The lack of potable water and sanitation facilities contributes to the spread of disease and higher infant mortality. The priority problems accounting for the largest portion of neonatal and infant mortality in the region are 1) perinatal problems and lack of prenatal care, 2) intestinal and respiratory infections, 3) vaccine-preventable diseases, 4) malnutrition, and 5) high-risk fertility behavior. Since the introduction of the Expanded Program on Immunization and the Program for the Control of Diarrheal Diseases in the 1970s, the level and character of infant mortality have changed dramatically in the region. Vaccine-preventable diseases are no longer among the 5 principal causes of infant mortality. The highly effective technologies used in the fight against diarrheal diseases have removed them from 1st place among causes of infant death in a number of countries. As a result, perinatal causes now rank 1st in 21 countries of the region. Low birth weight is a major factor associated with perinatal and infant mortality. 1 of the most important means of reducing infant mortality is to improve the social and economic situation of families--for example, by educating women and providing the social support necessary for a healthy family.^ieng
Subject(s)
Infant Mortality , Americas , Cause of Death , Child Health Services/supply & distribution , Humans , Infant , Infant, Newborn , Socioeconomic FactorsABSTRACT
In this article the term health manpower is applied to members of society who have acquired specific training and taken on responsibilities in health work. The different aspects of manpower development are viewed strictly from the standpoint of policy. They include the regulatory role of government and the influence of superstructure factors on decisions about health. There is a detailed discussion of the power relationships between decision-making groups and the organization of health services, and also of the role of knowledge as a power factor. The implementation of proposals on manpower depends on the operation of a sociopolitical process in which technical people who have the scientific ability and political sensitivity must participate to bring about changes that will benefit the majority.
