This document discusses the evolution of primary health care models for developing countries from the 1950s-1970s. It describes how the comprehensive primary health care model proposed at the 1978 Alma-Ata conference aimed to achieve health for all through universal access and addressing social determinants of health. However, selective primary health care, focusing on cost-effective disease interventions, was seen as more feasible. Some argue comprehensive primary health care was never truly implemented, while others view it as an experiment that failed. Debate continues on the best policy approach to improving global health.
Focusing Health Equity, Efficiency And Health Maximization Policy ReviewThant Zin
This document reviews approaches to maximize health equity, efficiency, and health outcomes. It discusses how investing in health, especially for the poor, promotes human development and economic productivity. Achieving equity in health access is important both intrinsically for individual well-being and instrumentally for social and economic benefits. The document analyzes factors like equity, efficiency, and sustainability that influence health maximization. It recommends reforms targeting universal healthcare coverage, people-centered services, integrated health planning, and community participation to improve health systems and outcomes for all.
This document summarizes and discusses a scholarly article about the Patient Protection and Affordable Care Act (PPACA) and its potential impact on elevating public health in the United States. Some key points:
1. PPACA includes many provisions aimed at prevention, wellness promotion and population health interventions, which could help shift the national focus from "sick care" to "health care".
2. However, the ultimate impact of these public health provisions will depend on future implementing regulations and funding appropriations.
3. Successfully implementing a broad public health agenda in the US may face significant cultural and political challenges, as attitudes toward government intervention and lifestyle choices differ from other countries with stronger public health systems.
Introduction to public health, definition, Preventive medicine vs public health, social medicine, community medicine, role of public health, public health practices, core activities
HEALTH PROMOTION AND PRIMARY HEALTH CARE.docxSuraj Pande
The document discusses health promotion and primary health care. It describes how health promotion emerged in the early 20th century to focus on individual health beyond just disease control. Primary health care was later established based on principles of equity, community participation, and multi-sectoral involvement. The key elements of primary health care include health education, nutrition, sanitation, maternal/child services, immunization, treatment, and essential drugs. Nurses play an important role in primary health care through health education, nutrition programs, sanitation, maternal/child services, immunization, and treating minor ailments. Problems implementing primary health care in India include lack of resources, large population, and inequitable distribution of health services between rural and urban
Forty years ago, the Region of the Americas played a critical JeanmarieColbert3
Forty years ago, the Region of the Americas played a critical role in the develop-
ment and negotiation of the Alma-Ata Declaration, which identified primary health
care as a central strategy to the goal of health for all and a comprehensive approach to
the organization of health systems. Since then, the values and principles of primary
health care, which include the right to health, equity, solidarity, social justice and par-
ticipation, and multisectoral action, among others, have formed the basis of many
PAHO mandates and have guided health systems transformation in the Region. The
positive impact of primary health care on the reduction of mortality, morbidity, and
inequities in health is well known. (1) What’s more, primary health care consumes less
financial resources than curative approaches and promotes a chain of positive results
from improved health to increased economic output, growth and productivity. (2)
In 2007, PAHO’s position paper on Renewing Primary Health Care in the Americas
included the definition of elements and functions of a primary healthcare-based
health system with the intention of providing guidance to countries as they worked
to transform their systems. (3) In 2014, the 53rd PAHO Directing Council’s resolution
on Universal Access to Health and Universal Health Coverage (4) recognized the
values and principles of Alma-Ata. The resolution urged PAHO Member States to
promote intersectoral action to address social determinants of health and move
toward health systems where all people and communities have access, without any
discrimination, to comprehensive, appropriate and timely, quality health services, as
well as access to safe, effective, and affordable quality medicines, while ensuring that
the use of such services does not expose users to financial difficulties. (4) The Sustai-
nable Health Agenda for the Americas 2018–2030, which represents the commitment
of Member States to the 2030 Agenda for Sustainable Development and unfinished
business from previous engagements, established areas of action that reinforce and
complement the recommendations of the Alma-Ata Declaration. These include stren-
gthening the national health authority; tackling health determinants; increasing so-
cial protection and access to quality health services; diminishing health inequalities
among countries and inequities within them; reducing the risk and burden of disease;
strengthening the management and development of health workers; harnessing
knowledge, science, and technology; and strengthening health security. (5)
In the Region, the lessons that have been learned about the primary health care
approach since Alma-Ata have been overwhelmingly positive. We have seen that
countries that have implemented policies and programs based on primary health
care have registered the lowest levels of infant and maternal mortality. Other achie-
vements include improvement in public spending, increase in primary care s ...
discussion on Health Economics and Health Care in our country and abroad, and what resources are given by the private sectors and with the very scarce help from the DOH, national and local government, and from the support given by WHO.
This document discusses the evolution of primary health care models for developing countries from the 1950s-1970s. It describes how the comprehensive primary health care model proposed at the 1978 Alma-Ata conference aimed to achieve health for all through universal access and addressing social determinants of health. However, selective primary health care, focusing on cost-effective disease interventions, was seen as more feasible. Some argue comprehensive primary health care was never truly implemented, while others view it as an experiment that failed. Debate continues on the best policy approach to improving global health.
Focusing Health Equity, Efficiency And Health Maximization Policy ReviewThant Zin
This document reviews approaches to maximize health equity, efficiency, and health outcomes. It discusses how investing in health, especially for the poor, promotes human development and economic productivity. Achieving equity in health access is important both intrinsically for individual well-being and instrumentally for social and economic benefits. The document analyzes factors like equity, efficiency, and sustainability that influence health maximization. It recommends reforms targeting universal healthcare coverage, people-centered services, integrated health planning, and community participation to improve health systems and outcomes for all.
This document summarizes and discusses a scholarly article about the Patient Protection and Affordable Care Act (PPACA) and its potential impact on elevating public health in the United States. Some key points:
1. PPACA includes many provisions aimed at prevention, wellness promotion and population health interventions, which could help shift the national focus from "sick care" to "health care".
2. However, the ultimate impact of these public health provisions will depend on future implementing regulations and funding appropriations.
3. Successfully implementing a broad public health agenda in the US may face significant cultural and political challenges, as attitudes toward government intervention and lifestyle choices differ from other countries with stronger public health systems.
Introduction to public health, definition, Preventive medicine vs public health, social medicine, community medicine, role of public health, public health practices, core activities
HEALTH PROMOTION AND PRIMARY HEALTH CARE.docxSuraj Pande
The document discusses health promotion and primary health care. It describes how health promotion emerged in the early 20th century to focus on individual health beyond just disease control. Primary health care was later established based on principles of equity, community participation, and multi-sectoral involvement. The key elements of primary health care include health education, nutrition, sanitation, maternal/child services, immunization, treatment, and essential drugs. Nurses play an important role in primary health care through health education, nutrition programs, sanitation, maternal/child services, immunization, and treating minor ailments. Problems implementing primary health care in India include lack of resources, large population, and inequitable distribution of health services between rural and urban
Forty years ago, the Region of the Americas played a critical JeanmarieColbert3
Forty years ago, the Region of the Americas played a critical role in the develop-
ment and negotiation of the Alma-Ata Declaration, which identified primary health
care as a central strategy to the goal of health for all and a comprehensive approach to
the organization of health systems. Since then, the values and principles of primary
health care, which include the right to health, equity, solidarity, social justice and par-
ticipation, and multisectoral action, among others, have formed the basis of many
PAHO mandates and have guided health systems transformation in the Region. The
positive impact of primary health care on the reduction of mortality, morbidity, and
inequities in health is well known. (1) What’s more, primary health care consumes less
financial resources than curative approaches and promotes a chain of positive results
from improved health to increased economic output, growth and productivity. (2)
In 2007, PAHO’s position paper on Renewing Primary Health Care in the Americas
included the definition of elements and functions of a primary healthcare-based
health system with the intention of providing guidance to countries as they worked
to transform their systems. (3) In 2014, the 53rd PAHO Directing Council’s resolution
on Universal Access to Health and Universal Health Coverage (4) recognized the
values and principles of Alma-Ata. The resolution urged PAHO Member States to
promote intersectoral action to address social determinants of health and move
toward health systems where all people and communities have access, without any
discrimination, to comprehensive, appropriate and timely, quality health services, as
well as access to safe, effective, and affordable quality medicines, while ensuring that
the use of such services does not expose users to financial difficulties. (4) The Sustai-
nable Health Agenda for the Americas 2018–2030, which represents the commitment
of Member States to the 2030 Agenda for Sustainable Development and unfinished
business from previous engagements, established areas of action that reinforce and
complement the recommendations of the Alma-Ata Declaration. These include stren-
gthening the national health authority; tackling health determinants; increasing so-
cial protection and access to quality health services; diminishing health inequalities
among countries and inequities within them; reducing the risk and burden of disease;
strengthening the management and development of health workers; harnessing
knowledge, science, and technology; and strengthening health security. (5)
In the Region, the lessons that have been learned about the primary health care
approach since Alma-Ata have been overwhelmingly positive. We have seen that
countries that have implemented policies and programs based on primary health
care have registered the lowest levels of infant and maternal mortality. Other achie-
vements include improvement in public spending, increase in primary care s ...
discussion on Health Economics and Health Care in our country and abroad, and what resources are given by the private sectors and with the very scarce help from the DOH, national and local government, and from the support given by WHO.
Global health initiatives aim to improve health and healthcare equity worldwide through both medical and non-medical efforts. They rose alongside globalization and increased public awareness of shared global health challenges. Major initiatives work towards the UN's 8 Millennium Development Goals, including eradicating poverty and hunger, improving education, gender equality, child and maternal health, and combating diseases. Key organizations coordinating global efforts include the WHO, World Bank, Global Fund, GAVI, and others working in areas like immunization, tuberculosis, malaria, non-communicable diseases, and more. Overall, global health initiatives are needed for nations to work together towards the important goal of saving lives and improving health outcomes globally.
LuciousDavis1-Practices in Public Health-01-Unit9_ AssignmentLucious Davis
The document discusses improving global public health through international collaboration. It describes the Global Health Security Agenda created to work with nations and organizations to prevent infectious diseases. Eleven action plans were developed to implement strategies like educating the public on health risks. However, lack of funding is a barrier to properly resourcing programs. Greater investment is needed to address health inequalities and control diseases worldwide in our increasingly interconnected world.
This document summarizes a research article that examined the state of health education and community mobilization in Nigeria's healthcare delivery system. It discusses how community mobilization and participation plays a key role in utilizing health services. It also reviews how health education and primary healthcare have been implemented in Nigeria historically. While there are challenges, the document outlines prospects for health education in Nigeria, including its potential to help achieve important development goals and encourage moral and ethical values in communities.
Public health policy development in developing countries Ruby Med Plus
Public Health policy development in developing countries is addressed by four policy questions:
1. Does the introduction of a health policy at national, international level imply corresponding improvement in the quality of health of a country/population?
2. For effective health systems with efficient outcome: should health related policies be locally/nationally or internationally motivated (initiated)?
3. Should developing countries rely on the West for changes in the health of their population?
4. What is the impact of health policies adopted at the international scene on the health of populations in developing countries?
Global health is an important new term, and an important new concept. The Institute of Medicine refers to global health as "health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions."
OBJECTIVES OF GLOBAL HEALTH CARE
Why should medical students learn about global health
CONTINUE…
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CHALLENGES IN GLOBAL HEALTH CARE
THE KEY CONCEPTS IN RELATION TO GLOBAL HEALTH
. THE DETERMINANTS OF HEALTH
CONTINUE..
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Continue…
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5. Key Risk Factors for Various Health Conditions
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HEALTH PATTERNS IN RESOURCE POOR COUNTRIES
HEALTH PATTERNS IN RESOURCE RICH COUNTRIES
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REFERENCES
THANK YOU
This document discusses the relationship between nutrition, health, and economic development. It states that malnutrition negatively impacts economic development by increasing mortality and morbidity, especially in children and women. Poor nutrition lowers educational performance and cognitive ability due to issues like iodine and iron deficiencies. However, improved nutrition can boost economic growth by increasing labor productivity and utilization of resources. Overall, better health and nutrition are closely tied to individual and national well-being and prosperity.
This document provides an overview of public health and the role of pharmacists in social health and disease prevention programs. It defines public health as a societal effort to protect, promote, and restore the health of all people. The objectives of public health are outlined as reducing disease, premature death, discomfort, and disability. Core public health functions include monitoring health status, educating the public, and enforcing laws to protect health. A history of the development of public health organizations and services in the US is provided. The document also describes various health service programs in India at the national, state, and local levels aimed at disease prevention and health promotion.
This document provides an overview of pharmacy education and training in a global and national context. Globally, organizations like FIP and academic pharmacy sections are working to promote harmonization of pharmacy education worldwide. Nationally, the document discusses Zambia's health system and the development of the country's pharmacy education program. It was established through collaboration between the University of Zambia, Ministry of Health, and professional bodies to train registrable pharmacists through academic and practice-based components. The goals of pharmacy education are also outlined, including developing skills in various areas and providing scientific, academic, and professional knowledge bases.
are increasing the importance of environmental ethics has started to take pre...KhalidMdBahauddin
are increasing the importance of environmental ethics has started to take precedence making its global issue. as this issue do not respect National boundaries
Charles-Edward Armory Winslow defined public health as "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals." Modern public health is multidisciplinary, multisectoral, evidence-based, and equity-oriented. It assesses population health, plans and implements programs, identifies environmental hazards, and communicates to promote public health.
Scope of Health Promotion included in National Health Policy (NHP) 2071(2014)Mohammad Aslam Shaiekh
The document summarizes the scope of health promotion as outlined in Nepal's 2014 National Health Policy. It discusses how health promotion aims to enable people to increase control over their health through various individual, interpersonal, community, and policy-level strategies. The National Health Policy includes policies and over 120 strategies to promote public health through health education and communication, minimize malnutrition by promoting healthy foods, and ensure citizens' right to a healthy environment by controlling pollution. The policy aims to address health promotion through a strategic framework that focuses on reorienting services, creating supportive environments, reducing inequalities, improving health, preventing diseases, and reducing healthcare costs.
The document discusses primary health care (PHC) in India. It defines PHC as essential health care that is universally accessible and affordable. The ultimate goal of PHC is better health services for all through equitable distribution and community participation. The key principles of PHC outlined in the Alma-Ata Declaration include intersectoral coordination using appropriate technology. Approaches to PHC include selective PHC, which focuses on combating major diseases, and programs like GOBI-FFF that target growth monitoring, oral rehydration, breastfeeding, immunization, and other interventions. Services provided through PHC in India include maternal and child health care, immunization, disease prevention and control, and essential drug provision. PHC
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
HCS 410(2) ACA Tittle IV-Prevention of Chronic diseasesMaria Jimenez
The document summarizes key aspects of the Affordable Care Act as it relates to prevention and wellness. It describes how the ACA aims to promote prevention, fund public health initiatives, and reduce chronic disease. It discusses provisions such as banning pre-existing condition exclusions, covering preventive services with no cost sharing, and investing in community-based prevention programs. However, it also notes that Republicans questioned whether these prevention initiatives were worth funding.
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptxKathrynDetablan
The document summarizes public health nursing and the primary health care system in the Philippines. It describes the roles of community health nurses which include being a clinician, health educator, facilitator, supervisor, health advocate, and collaborator. It also outlines the key elements of primary health care as promoted by the WHO, including environmental sanitation, disease control, immunization, health education, maternal and child health services, nutrition programs, and access to essential drugs and medical treatment. The primary health care approach aims to make basic health services universally accessible through people-centered and multi-sectoral involvement at the community level.
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptxKathrynDetablan
The document summarizes public health nursing in the Philippines. It discusses how community health nursing has evolved in response to global and local health trends, positioning nurses as leaders in health promotion. It outlines the roles of community health nurses as clinicians, educators, facilitators, supervisors, and advocates. It also describes the Philippine healthcare system, including the human resources challenges and primary healthcare approach centered on people and multi-sectoral involvement to achieve universal health coverage.
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptxKathrynDetablan
The document summarizes public health nursing in the Philippines. It outlines the roles of community health nurses which include being a clinician, health educator, facilitator, supervisor, health advocate, and collaborator. It also describes the country's health care delivery system, noting issues like uneven distribution of health resources and a strong private sector. Primary health care is discussed as the approach to make essential services universally accessible through community participation and multisectoral involvement. The key elements of primary health care include environmental sanitation, disease control, immunization, and ensuring access to medical care, nutrition, and essential drugs.
Responsibility of Health Promotion in Nursing Research Paper.docxwrite22
1) Health promotion aims to empower communities and individuals to increase control over their health by developing personal skills and changing social and environmental conditions.
2) Nurses play an important role in health promotion through education, helping patients understand their conditions, and communicating the benefits of preventive health measures.
3) There are three levels of health promotion - primary prevention prevents disease through measures like immunization; secondary prevention detects disease early through screening to limit effects; and tertiary prevention helps manage existing conditions and promote adjustment.
Sec. S-i. Med. Vol. 38, No. 2, pp. 205-215, 1994 Printed in .docxbagotjesusa
Sec. S-i. Med. Vol. 38, No. 2, pp. 205-215, 1994
Printed in Great Britain.
THE HOUSEHOLD PRODUCTION
0277.9536/94 $6.00 + 0.00
Pergamon Press Ltd
OF HEALTH:
INTEGRATING SOCIAL SCIENCE PERSPECTIVES ON
MICRO-LEVEL HEALTH DETERMINANTS
PETER BERMAN’, CARL KENDALL’ and KARABI BHATTACHARYYA’
‘Department of Population and International Health, Harvard School of Public Health , 665 Huntington
Avenue, Boston, MA 02115 and ‘Department of International Health, School of Hygiene and Public
Health. The Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, U.S.A.
Abstract-Efforts to control disease and improve health in developing countries require increasing
collaboration between social and medical scientists. This collaboration should extend from the early stages
of technology development to the evaluation and improvement of population-wide interventions. This
paper provides an integrating framework for social science research on health producing processes at the
household level, drawing on recent work in economics, anthropology, and public health. Further
development of theory and methods in this area would benefit from interdisciplinary research in categories
as defined by social and behavioral science in addition to those related to specific diseases and intervention
programs.
Key words-health, development, social science methods. household economics
The natural locus of disease is the natural locus of life - the
family: gentle, spontaneous care, expressive of love and a
common desire for a cure, assists nature in its struggle
against the illness, and allows the illness itself to attain its
own truth [I, p.171.
lNTRODUCTION
In medicine and public health in developing
countries, technology has captured center stage. Oral
rehydration therapy, vitamin supplements, recombi-
nant vaccines-these are the vanguard of the ‘revolu-
tion’ in child survival. Whereas once the eradication
of a single disease was a dream, today elimination of
a host of killers is deemed a likelihood.
While technology can certainly hasten public
health improvements, historical experience suggests
that other factors are also needed. As is well known,
major health improvements in the West preceded
rather than accompanied the advent of antibiotics
and most vaccines [2]. Some low income countries
and regions have achieved levels of infant mortality
below those of some American cities with low cost,
decentralized systems of primary health care [3].
There is reason to believe that such successes of
health development depend on a combination of
appropriate technology, sound health care delivery,
and social and economic changes affecting house-
holds and communities. Where health care provision
of adequate quality or related social advances are
absent or lagging, simple mass extension of clinically
efficacious medical techniques, such as promotion of
oral rehydration may exhibit high initial rates of
success and r.
KATIES POST The crisis case I chose to discuss this week is th.docxdonnajames55
KATIE'S POST:
The crisis case I chose to discuss this week is the Tennessee Valley and the Kingston ash slide. On December 22, 2008, Tennessee Valley Authority who uses coal to generate electricity, had one of their containment pods that holds sludge from the ash wall begin to leak. The leak then caused the wall to eventually crumble. The leak then flowed into the Emory River that is located nearby. The river flowed into a nearby community, destroyed several houses, and forced families to evacuate the area.
Chapter 5 discusses the importance of organization members accepting that crisis can start quickly and unexpectedly. Two months before the leak, TVA was informed of a wet spot located on one retaining wall that suggested a leak was present. The moisture was eroding the structure's integrity, but TVA continued to add ash to the pond. TVA organization leaders ignored the warning signs of a potential crisis. TVA then accepted blame for the spill and began dredging the Emory River shortly after the incident. No other independent party was allowed to assess the dredging plan before it launched. If TVA's plan failed, the organization would have been at fault once again.
Upon further investigation of the crisis, lawyers were able to identify six primary failures in TVA's systems, controls, standards, and culture. “Lack of clarity and accountability for ultimate responsibility, lack of standardization, training, and metrics, siloed responsibilities and poor communication, lack of checks and balances, lack of prevention priority and resources, and being reactive instead of proactive” (Ulmer, Sellnow,& Seeger, 87).
Unfortunately, this unintentional crises could have been avoided had the proper crisis management, quality assurance, and procedures been put in place. TVA's negligence cost people their homes, polluted the river, and the uncertainty of long-term health conditions from being exposed to the ash's toxins. "The community was not able to locate reliable information about potential short- and long-term health effects, uncertainty about the extent of environmental damage, and feared plummeting property values" (Ritchie, Little, & Campbell, 179). TVA was at fault for several things, but the most significant fault they did not consider is the risk of storing large volumes of fly ash near the Emory River that flowed into a nearby community.
Ulmer, R. R., Sellnow, T. L., & Seeger, M. W. (2017). Effective crisis communication: Moving from crisis to opportunity. Sage Publications.
Ritchie, L. A., Little, J., & Campbell, N. M. (2018). Resource Loss and Psychosocial Stress in the Aftermath of the 2008 Tennessee Valley Authority Coal Ash Spill. International journal of mass emergencies and disasters, 36(2), 179.
.
Kate Chopins concise The Story of an Hour. What does Joseph.docxdonnajames55
Kate Chopin's concise "The Story of an Hour".
* What does Josephine represent in the story? What does Richards represent?
*The doctors said Mrs. M. died of "heart disease - of joy that kills." How is this ironic?
* What are some themes in the story? What are some symbols?
.
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This document discusses the relationship between nutrition, health, and economic development. It states that malnutrition negatively impacts economic development by increasing mortality and morbidity, especially in children and women. Poor nutrition lowers educational performance and cognitive ability due to issues like iodine and iron deficiencies. However, improved nutrition can boost economic growth by increasing labor productivity and utilization of resources. Overall, better health and nutrition are closely tied to individual and national well-being and prosperity.
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The document summarizes public health nursing and the primary health care system in the Philippines. It describes the roles of community health nurses which include being a clinician, health educator, facilitator, supervisor, health advocate, and collaborator. It also outlines the key elements of primary health care as promoted by the WHO, including environmental sanitation, disease control, immunization, health education, maternal and child health services, nutrition programs, and access to essential drugs and medical treatment. The primary health care approach aims to make basic health services universally accessible through people-centered and multi-sectoral involvement at the community level.
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptxKathrynDetablan
The document summarizes public health nursing in the Philippines. It discusses how community health nursing has evolved in response to global and local health trends, positioning nurses as leaders in health promotion. It outlines the roles of community health nurses as clinicians, educators, facilitators, supervisors, and advocates. It also describes the Philippine healthcare system, including the human resources challenges and primary healthcare approach centered on people and multi-sectoral involvement to achieve universal health coverage.
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptxKathrynDetablan
The document summarizes public health nursing in the Philippines. It outlines the roles of community health nurses which include being a clinician, health educator, facilitator, supervisor, health advocate, and collaborator. It also describes the country's health care delivery system, noting issues like uneven distribution of health resources and a strong private sector. Primary health care is discussed as the approach to make essential services universally accessible through community participation and multisectoral involvement. The key elements of primary health care include environmental sanitation, disease control, immunization, and ensuring access to medical care, nutrition, and essential drugs.
Responsibility of Health Promotion in Nursing Research Paper.docxwrite22
1) Health promotion aims to empower communities and individuals to increase control over their health by developing personal skills and changing social and environmental conditions.
2) Nurses play an important role in health promotion through education, helping patients understand their conditions, and communicating the benefits of preventive health measures.
3) There are three levels of health promotion - primary prevention prevents disease through measures like immunization; secondary prevention detects disease early through screening to limit effects; and tertiary prevention helps manage existing conditions and promote adjustment.
Sec. S-i. Med. Vol. 38, No. 2, pp. 205-215, 1994 Printed in .docxbagotjesusa
Sec. S-i. Med. Vol. 38, No. 2, pp. 205-215, 1994
Printed in Great Britain.
THE HOUSEHOLD PRODUCTION
0277.9536/94 $6.00 + 0.00
Pergamon Press Ltd
OF HEALTH:
INTEGRATING SOCIAL SCIENCE PERSPECTIVES ON
MICRO-LEVEL HEALTH DETERMINANTS
PETER BERMAN’, CARL KENDALL’ and KARABI BHATTACHARYYA’
‘Department of Population and International Health, Harvard School of Public Health , 665 Huntington
Avenue, Boston, MA 02115 and ‘Department of International Health, School of Hygiene and Public
Health. The Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, U.S.A.
Abstract-Efforts to control disease and improve health in developing countries require increasing
collaboration between social and medical scientists. This collaboration should extend from the early stages
of technology development to the evaluation and improvement of population-wide interventions. This
paper provides an integrating framework for social science research on health producing processes at the
household level, drawing on recent work in economics, anthropology, and public health. Further
development of theory and methods in this area would benefit from interdisciplinary research in categories
as defined by social and behavioral science in addition to those related to specific diseases and intervention
programs.
Key words-health, development, social science methods. household economics
The natural locus of disease is the natural locus of life - the
family: gentle, spontaneous care, expressive of love and a
common desire for a cure, assists nature in its struggle
against the illness, and allows the illness itself to attain its
own truth [I, p.171.
lNTRODUCTION
In medicine and public health in developing
countries, technology has captured center stage. Oral
rehydration therapy, vitamin supplements, recombi-
nant vaccines-these are the vanguard of the ‘revolu-
tion’ in child survival. Whereas once the eradication
of a single disease was a dream, today elimination of
a host of killers is deemed a likelihood.
While technology can certainly hasten public
health improvements, historical experience suggests
that other factors are also needed. As is well known,
major health improvements in the West preceded
rather than accompanied the advent of antibiotics
and most vaccines [2]. Some low income countries
and regions have achieved levels of infant mortality
below those of some American cities with low cost,
decentralized systems of primary health care [3].
There is reason to believe that such successes of
health development depend on a combination of
appropriate technology, sound health care delivery,
and social and economic changes affecting house-
holds and communities. Where health care provision
of adequate quality or related social advances are
absent or lagging, simple mass extension of clinically
efficacious medical techniques, such as promotion of
oral rehydration may exhibit high initial rates of
success and r.
Similar to Comprehensive Versus SelectivePrimary Health Care Lessons.docx (20)
KATIES POST The crisis case I chose to discuss this week is th.docxdonnajames55
KATIE'S POST:
The crisis case I chose to discuss this week is the Tennessee Valley and the Kingston ash slide. On December 22, 2008, Tennessee Valley Authority who uses coal to generate electricity, had one of their containment pods that holds sludge from the ash wall begin to leak. The leak then caused the wall to eventually crumble. The leak then flowed into the Emory River that is located nearby. The river flowed into a nearby community, destroyed several houses, and forced families to evacuate the area.
Chapter 5 discusses the importance of organization members accepting that crisis can start quickly and unexpectedly. Two months before the leak, TVA was informed of a wet spot located on one retaining wall that suggested a leak was present. The moisture was eroding the structure's integrity, but TVA continued to add ash to the pond. TVA organization leaders ignored the warning signs of a potential crisis. TVA then accepted blame for the spill and began dredging the Emory River shortly after the incident. No other independent party was allowed to assess the dredging plan before it launched. If TVA's plan failed, the organization would have been at fault once again.
Upon further investigation of the crisis, lawyers were able to identify six primary failures in TVA's systems, controls, standards, and culture. “Lack of clarity and accountability for ultimate responsibility, lack of standardization, training, and metrics, siloed responsibilities and poor communication, lack of checks and balances, lack of prevention priority and resources, and being reactive instead of proactive” (Ulmer, Sellnow,& Seeger, 87).
Unfortunately, this unintentional crises could have been avoided had the proper crisis management, quality assurance, and procedures been put in place. TVA's negligence cost people their homes, polluted the river, and the uncertainty of long-term health conditions from being exposed to the ash's toxins. "The community was not able to locate reliable information about potential short- and long-term health effects, uncertainty about the extent of environmental damage, and feared plummeting property values" (Ritchie, Little, & Campbell, 179). TVA was at fault for several things, but the most significant fault they did not consider is the risk of storing large volumes of fly ash near the Emory River that flowed into a nearby community.
Ulmer, R. R., Sellnow, T. L., & Seeger, M. W. (2017). Effective crisis communication: Moving from crisis to opportunity. Sage Publications.
Ritchie, L. A., Little, J., & Campbell, N. M. (2018). Resource Loss and Psychosocial Stress in the Aftermath of the 2008 Tennessee Valley Authority Coal Ash Spill. International journal of mass emergencies and disasters, 36(2), 179.
.
Kate Chopins concise The Story of an Hour. What does Joseph.docxdonnajames55
Kate Chopin's concise "The Story of an Hour".
* What does Josephine represent in the story? What does Richards represent?
*The doctors said Mrs. M. died of "heart disease - of joy that kills." How is this ironic?
* What are some themes in the story? What are some symbols?
.
K-2nd Grade
3rd-5th Grade
6th-8th Grade
Major Concepts, Principles, and Learning Theories (To be completed in Topic 3)
Cognitive
Linguistic
Social
Emotional
Physical
.
Just Walk on By by Brent Staples My firs.docxdonnajames55
Just Walk on By
by Brent Staples
My first victim was a woman—white, well dressed, probably in
her early twenties. I came upon her late one evening on a deserted street
in Hyde Park, a relatively affluent neighborhood in an otherwise mean,
impoverished section of Chicago. As I swung onto the avenue behind her,
there seemed to be a discreet, uninflammatory distance between us. Not so.
She cast back a worried glance. To her, the youngish black man—a broad
six feet two inches with a beard and billowing hair, both hands shoved
into the pockets of a bulky military jacket—seemed menacingly close.
After a few more quick glimpses, she picked up her pace and was soon
running in earnest. Within seconds she disappeared into a cross street.
That was more than a decade ago. I was 23 years old, a graduate
student newly arrived at the University of Chicago. It was in the echo of
that terrified woman’s footfalls that I first began to know the unwieldy
inheritance I’d come into—the ability to alter public space in ugly ways. It
was clear that she thought herself the quarry of a mugger, a rapist, or
worse. Suffering a bout of insomnia, however, I was stalking sleep, not
defenseless wayfarers. As a softy who is scarcely able to take a knife
to raw chicken—let alone hold it to a person’s throat—I was surprised,
embarrassed, and dismayed all at once. Her flight made me feel like an
accomplice in tyranny. It also made it clear that I was indistinguishable
from the muggers who occasionally seeped into the area from the
surrounding ghetto. That first encounter, and those that followed signified
that a vast unnerving gulf lay between nighttime pedestrians—particularly
women—and me. And I soon gathered that being perceived as dangerous
is a hazard in itself. I only needed to turn a corner into a dicey situation,
or crowd some frightened, armed person in a foyer somewhere, or make
an errant move after being pulled over by a policeman. Where fear and
weapons meet—and they often do in urban America—there is always the
possibility of death.
In that first year, my first away from my hometown, I was to
become thoroughly familiar with the language of fear. At dark, shadowy
intersections in Chicago, I could cross in front of a car stopped at a traffic
light and elicit the thunk, thunk, thunk, thunk of the driver—black, white,
male, or female—hammering down the door locks. On less traveled streets
after dark, I grew accustomed to but never comfortable with people who
crossed to the other side of the street rather than pass me. Then there were
the standard unpleasantries with police, doormen, bouncers, cab drivers,
and others whose business it is to screen out troublesome individuals
before there is any nastiness.
I moved to New York nearly two years ago and I have remained an
avid night walker. In central Manhattan, the near-constant crowd cover
minimizes tense one-on-one stre.
Just make it simple. and not have to be good, its the first draft. .docxdonnajames55
Just make it simple. and not have to be good, it's the first draft.
I want it a complete essay of 2 pages before 10 am on Sunday.
The instructions in the second file. There is a picture in the third file.
CDT (Central Daylight Time)
UTC/GMT -5 hours
.
JUST 497 Senior Seminar and Internship ExperienceInternationa.docxdonnajames55
JUST 497: Senior Seminar and Internship Experience
International Film Critique: The Whistleblower
· Due: April 3
· Reaction Paper: 10 Points
· Presentation: 5 Points
Your first written assignment was to critique a newspaper article dealing with misconduct and/or corruption at a local level within the United States. The capstone essay asks you to consider a social injustice and its consequences that occur on a national level. The International film assignment asks you to consider issues of international law and justice.
The Whistleblower based on a true story depicts the horrors of human trafficking and human rights violations across international borders.
Please choose Assignment A or B.
Assignment A
Write a 3-4 page Reaction Paper to the above film. Summarize the producer’s main message in no more than a half page. The remainder of the paper should reflect your opinion of the content of the film based on your knowledge of international law. Make specific references to scenes in the film that correlate with information you have gained in previous or current coursework. Cite all sources in-text according to the Hacker & Sommers APA Manual of Style.
Cautionary Notes
· Do not summarize the video.
· Cite specific information from the film using the required APA Manual of style.
· Use 12 font, double spacing and 1 inch margins.
Students who need a special accommodation and cannot find a copy of a closed caption video, must meet with their instructor to design an alternative assignment.
Assignment B
The Whistleblower implicates the United Nations, the U.S. State Department, and private contractors in post war Bosnia in an organized human trafficking scheme. Kathryn Bolkovac discovers a lucrative, far-reaching operation involving the local police and United Nations peacekeepers, many of them protected by diplomatic immunity. This film is based on a true story and reflects the international concern with corruption and human trafficking.
Cast
· Kathryn Bolkovac: Nebraska police officer who accepts an offer to work with the U.N. International Police in Bosnia run by a private company in the U.K., Democra Security
· Madeleine Rees: Head of the United Nations Human Rights Commission
· Nick Kaufman: Kathryn’s Field Commander
· Peter Ward: Internal Affairs Specialist
· Luba, Raya and Irka: teenagers sold to the sex trafficking ring
· Fred Murray: Democra Security Officer
· John Blakely: Head of Human Resources
Based on the movie, address the following questions. Answers should be in a Question and Answer format and not essay style.
1. Discuss the suffering and oppression witnessed by (not experienced by) the main character. Cite specific scenes from the movie to support your discussion.
2. In whatspecific ways does Kathryn advocate for the victims she encounters? Cite scenes from the movie to support your answer.
3. Discuss how both local citizens and higher ranking officials contribute to organized corruption in post-war Bosn.
July 2002, Vol 92, No. 7 American Journal of Public Health E.docxdonnajames55
July 2002, Vol 92, No. 7 | American Journal of Public Health Editorial | 1057
⏐ EDITORIAL
A Code of
Ethics for
Public Health
The mandate to ensure and pro-
tect the health of the public is an
inherently moral one. It carries
with it an obligation to care for
the well-being of communities,
and it implies the possession of an
element of power to carry out
that mandate. The need to exer-
cise power to ensure the health of
populations and, at the same time,
to avoid abuses of such power are
at the crux of public health ethics.
Until recently, the ethical na-
ture of public health has been im-
plicitly assumed rather than ex-
plicitly stated. Increasingly,
however, society is demanding ex-
plicit attention to ethics. This de-
mand arises from technological
advances that create new possibil-
ities and, with them, new ethical
dilemmas; new challenges to
health, such as the advent of HIV;
and abuses of power, such as the
Tuskegee study of syphilis.
Medical institutions have been
more explicit about the ethical
elements of their practice than
have public health institutions.
However, the concerns of public
health are not fully consonant
with those of medicine. Thus, we
cannot simply translate the princi-
ples of medical ethics to public
health. In contrast to medicine,
public health is concerned more
with populations than with indi-
viduals, and more with prevention
than with cure. The need to artic-
ulate a distinct ethic for public
health has been noted by a num-
ber of public health professionals
and ethicists.1–5
A code of ethics for public
health can clarify the distinctive
elements of public health and the
ethical principles that follow from
or respond to those elements. It
can make clear to populations and
communities the ideals of the pub-
lic health institutions that serve
them, ideals for which the institu-
tions can be held accountable.
THE PROCESS OF
WRITING THE CODE
The backgrounds and perspec-
tives of people who identify
themselves as public health pro-
fessionals are as diverse as the
multitude of factors affecting the
health of populations. Articulating
a common ethic for this diverse
group is a formidable challenge.
In the spring of 2000, the gradu-
ating class of the Public Health
Leadership Institute chose writing
a code of ethics for public health
as a group project. The institute
provides advanced leadership
training to people who are al-
ready in leadership roles in pub-
lic health. Because the fellows
bring a wealth of experience from
a wide variety of public health in-
stitutions, they are uniquely able
to represent diverse perspectives
and identify ethical issues com-
mon in public health.
At the 2000 meeting of the Na-
tional Association of City and
County Health Officers, the group
added a non-institute member
( J. C. Thomas) and charted a plan
for working toward a code. The
plan included receiving a formal
charge as the code of ethics work-
ing group at the annual meeting of
the American Public Health Asso-
c.
Journals are to be 2 pages long with an introduction, discussion and.docxdonnajames55
Journals are to be 2 pages long with an introduction, discussion and conclusion. They must be double spaced. Your formatting, sentence structure, spell checking, etc., will all be taken into account.
Utilizing YouTube, do a search for and listen to at least two perspectives from CNN, Fox News and/or MSNBC regarding culture wars. Provide me with an analysis that discusses two different perspectives. I typed in CNN/Fox News/MSNBC and then culture war, and was able to find quite a few 5 minute vignettes with regard to the topic. If you find a discussion of the culture wars either in written form or at another site, you must insure that it is a legitimate source and provide a link to the site.
Make sure to first provide your understanding of the definition of culture wars as outlined in the text readings, then provide me with your analysis obtained from the news outlets.
.
Judgement in Managerial Decision MakingBased on examples fro.docxdonnajames55
Judgement in Managerial Decision Making
Based on examples from one of the recommended articles selected by you, the lecture notes, the text, and other sources, discuss one or several of the themes: the nature of managerial decision making, the steps in the managerial decision making, organizational learning and creativity, judgmental heuristics, common biases in managerial decision making, bounds of human judgment, strategies for making better decisions.
.
Joyce is a 34-year-old woman who has been married 10 years. She .docxdonnajames55
Joyce is a 34-year-old woman who has been married 10 years. She has three children, all less than 10 years old: Sheena (age 9), Jack (age 6), and Beth (age 2). Her husband is a prominent attorney. They present an ideal picture of an upper-middle-class family. They live in a fashionable suburb. The husband has been successful to the extent that he has been made a full partner in a large law firm. The family is very active in church, the country club, and various other social organizations. Joyce is an active member of several charitable, civic, and social groups. Joyce’s initial call to the abuse center was vague and guarded. She expressed an interest in inquiring for “another woman” in regard to the purpose of the center. After she had received information and an invitation to call back, a number of weeks elapsed. Joyce’s second call occurred after receiving a severe beating from her husband.
Joyce tells the crisis worker in the phone:"Well, last night he beat me worse than ever. I thought he was really going to kill me this time. It had been building up for the past few weeks. His fuse was getting shorter and shorter, both with me and the kids. It’s his work, I guess. Finally he came home late last night. Dinner was cold. We were supposed to go out, and I guess it was my fault . . . I complained about his being late, and he blew up. Started yelling that he was gonna teach me a lesson. He started hitting me with his fists . . .knocked me down . . . and then started kicking me. I got up and ran into the bathroom. The kids were yelling for him to stop and he cuffed Sheena . . . God, it was horrible! (Wracked with sobs for more than a minute. CW waits.) I’m sorry, I just can’t seem to keep control."
As the crisis worker:
1-What typical dynamics did you see occurring—denial, guilt, fear, rationalization, withdrawal, and so on—in the victim? How would you as the crisis worker handle them?
What are some of the domestic violence intervention strategies? Pick one and how would you apply it to the scenario
.
Journal Write in 300-500 words about the following topic.After .docxdonnajames55
Journal: Write in 300-500 words about the following topic.
After watching some news and some television shows, including movies and anime. What are some portrayals of sexual harassment and rape myths that are perpetuated by social media, entertainment media, and news outlets?
What is the motivation of rapists on TV and in the movies?
What “types” of women get raped or sexually assaulted and harassed in movies and television?
Some research suggests that on TV and in the movies nontraditional women get raped more often than traditional women as a means of putting nontraditional women “in their place.”
How does what you saw compare to the research? How do gender stereotypes perpetuate rape and harassment culture?
In your experience or opinion, what are some ways society can address some of these issues around sexual assault and sexual battery, especially on college campuses and workplaces?
.
Journal Supervision and Management StyleWhen it comes to superv.docxdonnajames55
Journal: Supervision and Management Style
When it comes to supervising and managing personnel in human services organizations, everyone has his or her own leadership style. Some styles are effective and supportive; others may be ineffectual and unhelpful. When supervising and managing staff, it is important for human services administrators to first identify their leadership style and examine personal strengths and weaknesses related to their leadership style. Understanding how to utilize strengths and address weaknesses in leadership style is important for administrators to be both effective and supportive when supervising and managing.
In order to complete the Application Assignment, you must first complete the "Types of Leadership and Patterns of Management" interactive graphic provided in the Learning Resources. Once you have done so, take note of your leadership style and think about your areas of strengths and weaknesses.
After completing the self-assessment tool in this week’s Learning Resources, reflect on the results.
RESULTS:
I am very good at executing the work of a task, though I like clarity about the desired outcome.
1.
Engaging
2.
I really prefer to be peaceful and calm, finding ways to help others achieve their goals
3.
Achieving consensus among followers assures the best success
4.
It is ok to breech boundaries if we can all move in the same direction
5.
Being a change agent is never easy, but it is very stimulating for me
6.
I really prefer to be in control, though it does not have to be out in public
7.
Challenges should be addressed head on
8.
I like predictability
9.
I like to always put my best foot forward
10.
I am known to sometimes be argumentative, I believe it is the way new ideas emerge
11.
The best way to succeed is to trust oneself
12.
When determining goals to reach, we should always challenge ourselves a little beyond what we can see ourselves accomplishing
13.
The best way for me to relax is to spend some time alone quietly.
14.
When decisions are necessary my primary concern is its effect on the persons involved
15.
I am confident and assertive
16.
I am a compassionate person and there is significant value in the person (s) knowing where it comes from
17.
I am a very consistent person and am guided by my values
18.
I am a compassionate person but would rather show it behind the scenes
19.
I am conscientious and organized
20.Next
I like to focus on group cohesion
21.
When decisions are necessary I can make them easily and quickly as circumstances demand it
22.
My strong ability to envision the future makes me a result oriented leader
23.
Building and sustaining a strong image is a principle contributor to progress
24.
I see the big picture
25.
The best way for me to relax is to be reflective with a friend
26.
I am known to create harmony among others as it creates an optimal working environment. I am unimpressed with conflict
27.
Realistic
28.
I lik.
Journal of Social Work Values & Ethics, Fall 2018, Vol. 15, No.docxdonnajames55
Journal of Social Work Values & Ethics, Fall 2018, Vol. 15, No. 2 - page 37
Ethnicity, Values, and Value Conflicts of African
American and White Social Service Professionals
Andrew Edwards, MSW, Ph.D.
Cleveland State University, Emeritus
[email protected]
Mamadou M. Seck, Ph.D.
Cleveland State University
[email protected]
Journal of Social Work Values and Ethics, Volume 15, Number 2 (2018)
Copyright 2018, ASWB
This text may be freely shared among individuals, but it may not be republished in any medium without
express written consent from the authors and advance notification of ASWB.
Abstract
This aspect of a broader study included 110 (68
White/European American and 42 Black/African
American) social service professionals. The primary
focus of this aspect of the study was to verify the
value orientation or core beliefs of the practitioners
who deliver services to clients through social service
agencies and programs. The conceptualization
of the core beliefs explored the values and value
conflicts in relation to professional practice. The
participants were employed in a Midwestern
metropolitan region. They responded to a survey
instrument that included vignettes, closed-ended
items, scaled responses, as well as either-or type
items. Major categories of the exploration included:
life and death issues, lifestyle, domestic and
social perspectives, value conflicts with the social
work profession, and personal responses to value
conflicts. Specific items measuring values related
to abortion, homosexuality, religiosity, euthanasia,
and corporal punishment were included. Study
results showed statistical significance on 26 issues
as African American participants were compared
with White participants.
Keywords: value conflicts, social work, ethical
dilemmas, ethnicity, professional relationship
Introduction
The complexity of American society (Jarrett,
2000), specifically due to its historic, economic,
social, and ethnic makeup, requires that social
work professionals take their clients’ ethnicity,
values, and professional-client value conflicts
into consideration. Historical dynamics, such as
unproductive treatment, have contributed to the
reluctance of various population groups to engage
with professional service providers. This history
(Barker, 2014) has influenced the adoption of
guidelines that require social workers to be culturally
aware during interventions and recognizing that
diversity-related characteristics have influence upon
an individual’s thoughts, feelings, and behaviors.
Barker (2014) further noted that the concept of
values is influenced by one’s perceptions of what
comprises appropriate principles, practices, and
behaviors. An individual’s personal values are often
considered as a representation of one’s core beliefs
and what an individual may perceive as right.
Therefore, these beliefs do not require supporting
evidence for those who embrace them and may
result in behavio.
Journal of Personality 862, April 2018VC 2016 Wiley Perio.docxdonnajames55
Journal of Personality 86:2, April 2018
VC 2016 Wiley Periodicals, Inc.
DOI: 10.1111/jopy.12301Unique Associations Between Big
Five Personality Aspects and
Multiple Dimensions of Well-Being
Jessie Sun ,
1,2
Scott Barry Kaufman,
3
and
Luke D. Smillie
1
1
The University of Melbourne
2
University of California, Davis
3
University of Pennsylvania
Abstract
Objective: Personality traits are associated with well-being, but the precise correlates vary across well-being dimensions and
within each Big Five domain. This study is the first to examine the unique associations between the Big Five aspects (rather
than facets) and multiple well-being dimensions.
Method: Two samples of U.S. participants (total N 5 706; Mage 5 36.17; 54% female) recruited via Amazon’s Mechanical Turk
completed measures of the Big Five aspects and subjective, psychological, and PERMA well-being.
Results: One aspect within each domain was more strongly associated with well-being variables. Enthusiasm and Withdrawal
were strongly associated with a broad range of well-being variables, but other aspects of personality also had idiosyncratic
associations with distinct forms of positive functioning (e.g., Compassion with positive relationships, Industriousness with
accomplishment, and Intellect with personal growth).
Conclusions: An aspect-level analysis provides an optimal (i.e., parsimonious yet sufficiently comprehensive) framework for
describing the relation between personality traits and multiple ways of thriving in life.
Keywords: Personality, aspects, Big Five, subjective well-being, psychological well-being
When multiple positive end states are examined, it becomes
apparent that aspects of psychological well-being may be
achieved by more people than just the nonneurotic, extra-
verted members of society. (Schmutte & Ryff, 1997, p. 558)
The large literature describing the associations between person-
ality traits and well-being suggests that Extraversion (the tendency
to be bold, talkative, enthusiastic, and sociable) and Neuroticism
(the tendency to be emotionally unstable and prone to negative
emotions) are especially strong predictors of well-being (e.g.,
Steel, Schmidt, & Shultz, 2008). But is well-being only accessible
to the extraverted and non-neurotic? We propose that more
nuanced insights can be revealed by examining the relation
between narrower traits and a broader spectrum of well-being
dimensions. The goal of the current study is to comprehensively
describe the unique associations between personality aspects and
dimensions of well-being across three well-being taxonomies.
Personality Traits and Three Taxonomies
of Well-Being
Personality traits and well-being dimensions can each be
described at different levels of resolution. The Big Five domains
provide a relatively comprehensive framework for organizing
differential patterns of affect, behavior, and cognition (John,
Naumann, & Soto, 2008). These broad traits can be further bro-
ken dow.
Journal of Personality and Social Psychology1977, Vol. 35, N.docxdonnajames55
Journal of Personality and Social Psychology
1977, Vol. 35, No. 9, 677-688
Self-Reference and the Encoding of Personal Information
T. B. Rogers, N. A. Kuiper, and W. S. Kirker
University of Calgary, Canada
The degree to which the self is implicated in processing personal information
was investigated. Subjects rated adjectives on four tasks designed to force
varying kinds of encoding: structural, phonemic, semantic, and self-reference.
In two experiments, incidental recall of the rated words indicated that adjec-
tives rated under the self-reference task were recalled the best. These results
indicate that self-reference is a rich and powerful encoding process. As an
aspect of the human information-processing system, the self appears to func-
tion as a superordinate schema that is deeply involved in the processing, inter-
pretation, and memory of personal information.
Present research and theory in personality
appear to be placing more and more empha-
sis on how a person has organized his or her
psychological world. Starting with Kelly's
(1955) formulation of personal constructs,
we see a gradual emergence of a number of
avenues of inquiry that use this as their focal
point. In person perception, the concept of
lay personality theory stresses that the ob-
server's analytic network of expected trait
covariations is an integral part of how he
processes (and generates) interpersonal data
(Hastorf, Schneider, & Polefka, 1970). Bern
and Allen (1974), in their embellishment of
Allport's (1937) idiographic position, argue
that an important determinant of predictive
utility of trait measurement is the manner
in which the respondent has organized his or
her view of the trait being measured. These
authors see the overlap between the respond-
ent's and the experimenter's concept of the
trait as a necessary prerequisite of predic-
tion. Attribution theory (Jones et al., 1971)
is another example of this increased accent
on personal organization. Here the emphasis
is on how the subject explains past behavior
This research was supported by a grant from the
Canada Council. We would like to thank the fol-
lowing persons for their useful ideas and comments
on earlier drafts: F. I. M. Craik, E. J. Rowe, P. J.
Rogers, H. Lytton, J. Clark, J. Ells, C. G. Costello,
and especially one anonymous reviewer.
Requests for reprints should be sent to T. B.
Rogers, Department of Psychology, The University
of Calgary, Calgary, Alberta, Canada, T2N 1N4.
and how these explanations are organized in
an attributional network. The common
thread in all of these contemporary research
areas is the notion that the cognitions of a
person, particularly their manner of organ-
ization, should be an integral part of our
attempts to explain personality and behavior.
Of concern in the present article is the
construct of self and how it is implicated in
the organization of personal data. Our gen-
eral position is that the self is an extremely
active and powerful agent in the organizati.
Journal of Pcnonaluy and Social Psychology1»M. Vd 47, No 6. .docxdonnajames55
Journal of Pcnonaluy and Social Psychology
1»M. Vd 47, No 6. 1292-1302
Copynghi I9S4 by the
American Psychological Association. Inc
Influence of Gender Constancy and Social Power
on Sex-Linked Modeling
Kay Bussey
Macquarie University
New South Wales, Australia
Albert Bandura
Stanford University
Competing predictions derived from cognitive-developmental theory and social
learning theory concerning sex-linked modeling were tested. In cognitive-develop-
mental theory, gender constancy is considered a necessary prerequisite for the
emulation of same-sex models, whereas according to social learning theory, sex-
role development is promoted through a vast system of social influences with
modeling serving as a major conveyor of sex role information. In accord with
social learning theory, even children at a lower level of gender conception emulated
same-sex models in preference to opposite-sex ones. Level of gender constancy
was associated with higher emulation of both male and female models rather
than operating as a selective determinant of modeling. This finding corroborates
modeling as a basic mechanism in the sex-typing process. In a second experiment
we explored the limits of same-sex modeling by pitting social power against the
force of collective modeling of different patterns of behavior by male and female
models. Social power over activities and rewarding resources produced cross-sex
modeling in boys, but not in girls. This unexpected pattern of cross-sex modeling
is explained by the differential sex-typing pressures that exist for boys and girls
and socialization experiences that heighten the attractiveness of social power
for boys.
Most theories of sex role development as-
sign a major role to modeling as a basic
mechanism of sex role learning (Bandura,
1969; Kagan, 1964; Mischel, 1970; Sears,
Rau & Alpert, 1965). Maccoby and Jacklin
(1974) have questioned whether social prac-
tices or modeling processes are influential in
the development of sex-linked roles. They
point to findings that in laboratory situations
children do not consistently pattern their
This research was supported by Research Grant No.
M-S162-21 from the National Institute of Mental Health,
U.S. Public Health Services, and by the Lewis S. Haas
Child Development Research Fund, Stanford University.
We thank Martin Curland, Brad Carpenter, Brent Sha-
phren, Deborah Skriba, Erin Dignam, and Pamela Minet
for serving as models. We are indebted to Marilyn
Waterman for filming and editing the videotape modeling
sequence, to Eileen Lynch and Sara Buxton, who acted
as experimenters, and to Nancy Adams, who assisted in
collecting the data. Finally, we also thank the staff and
children from Bing Nursery School, Stanford University.
Requests for reprints should be sent to either Kay
Bussey, School of Behavioral Sciences, Macquarie Uni-
versity, North Ryde, Australia, 2113, or to Albert Bandura,
Department of Psychology, Stanford University, Building
420 Jordan Hall, Stanford,.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
Thinking of getting a dog? Be aware that breeds like Pit Bulls, Rottweilers, and German Shepherds can be loyal and dangerous. Proper training and socialization are crucial to preventing aggressive behaviors. Ensure safety by understanding their needs and always supervising interactions. Stay safe, and enjoy your furry friends!
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Comprehensive Versus SelectivePrimary Health Care Lessons.docx
1. Comprehensive Versus Selective
Primary Health Care: Lessons
For Global Health Policy
Meeting people’s basic health needs requires addressing the
underlying social, economic, and political causes of poor health.
by Lesley Magnussen, John Ehiri, and Pauline Jolly
ABSTRACT: Primary health care was declared the model for
global health policy at a 1978
meeting of health ministers and experts from around the world.
Primary health care re-
quires a change in socioeconomic status, distribution of
resources, a focus on health sys-
tem development, and emphasis on basic health services.
Considered too idealistic and ex-
pensive, it was replaced with a disease-focused, selective
model. After several years of
investment in vertical interventions, preventable diseases
remain a major challenge for de-
veloping countries. The selective model has not responded
adequately to the interrelation-
ship between health and socioeconomic development, and a
rethinking of global health
policy is urgently needed.
T
he health care systems of many developing countries emerged
from
colonial medical services that emphasized costly high-
technology, urban-
based, curative care.1 When these countries became
3. candidate in the Department of Epidemiology, School of
Public Health, at the University of Alabama at Birmingham
(UAB). John Ehiri ([email protected]) is an assistant
professor in the UAB Department of Maternal and Child Health.
Pauline Jolly is a professor of epidemiology and
international health at UAB.
Recognizing that narrow targets were not the only option,
countries attempted
to implement comprehensive approaches to the provision of
basic health services.
Examples included the creation of the rural health center,
staffed by medical and
health assistants and supported by the Bhore Commission in
India; the implemen-
tation of “community-based health programs” in Nicaragua,
Costa Rica, Guate-
mala, Honduras, Mexico, Bangladesh, and the Philippines; and
the barefoot doctor
program in China.7 As part of the overall efforts to improve
population health,
these countries brought a new theme to international health
discourse: commit-
ment to social equity in health services. Social equity means
that although different
socioeconomic levels exist, the gaps between those levels are
not insurmountable.8
Examples from these countries contributed to the optimism that
inequity could
be tackled to improve global health.
� Introduction of “health for all.” By the mid-1970s
international health agen-
4. cies and experts began to examine alternative approaches to
health improvement in
developing countries. The impressive health gains in China as a
result of its commu-
nity-based health programs and similar approaches elsewhere
stood in contrast to
the poor results of disease-focused programs. Soon this bottom-
up approach that
emphasized prevention and managed health problems in their
social contexts
emerged as an attractive alternative to the top-down, high-tech
approach and raised
optimism about the feasibility of tackling inequity to improve
global health. Thus,
“health for all” was introduced to global health planners and
practitioners by the
World Health Organization (WHO) and the United Nations
Children’s Fund
(UNICEF) at the International Conference on Primary Health
Care in Alma Ata,
Kazakhstan, in 1978.9 The declaration was intended to
revolutionize and reform pre-
vious health policies and plans used in developing countries,
and it reaffirmed
WHO’s definition of health in 1946: “a state of complete
physical, mental, and social
well being, and not merely the absence of disease or
infirmity.”10 The conference de-
clared that health is a fundamental human right and that
attainment of the highest
possible level of health was an important worldwide social goal.
To achieve the goal of health for all, global health agencies
pledged to work to-
ward meeting people’s basic health needs through a
comprehensive approach
5. called primary health care. Primary health care as envisioned at
Alma Ata had
strong sociopolitical implications. It explicitly outlined a
strategy that would re-
spond more equitably, appropriately, and effectively to basic
health needs and also
address the underlying social, economic, and political causes of
poor health.11 It
was to be underpinned by universal accessibility and coverage
on the basis of
need, with emphasis on disease prevention and health
promotion, community
participation, self-reliance, and intersectoral collaboration.12 It
acknowledged
that poverty, social unrest and instability, the environment, and
lack of basic re-
sources contribute to poor health status. It outlined eight
elements that future in-
terventions would use to fulfill the goal of health improvement:
education con-
cerning prevailing health problems and methods of preventing
and controlling
1 6 8 M a y / J u n e 2 0 0 4
A g r e e m e n t s
them; promotion of food supply and proper nutrition; an
adequate supply of safe
water and basic sanitation; maternal and child health care,
including family plan-
ning; immunization against major infectious diseases;
prevention and control of
locally endemic diseases; appropriate treatment of common
6. diseases and injuries;
and provision of essential drugs.
� Selective primary health care. One year after the Alma Alta
declaration, Julia
Walsh and Kenneth Warren presented “selective primary health
care” as an “in-
terim” strategy to begin the process of primary health care
implementation.13 They
argued that the best way to improve health was to fight disease
based on cost-effec-
tive medical interventions. Although they acknowledged that the
goal set at Alma
Ata was “above reproach,” they contended that its scope and
resource constraints
made it unattainable. They proposed that a selective attack on a
region’s most severe
public health problems would maximize improvement of health
in developing coun-
tries. They identified four factors to guide the selection of
target diseases for preven-
tion and treatment: prevalence, morbidity, mortality, and
feasibility of control (in-
cluding efficacy and cost). Thus, rather than the envisioned
emphasis on
development and sustainability of health systems and
infrastructures to improve
population health, primary health care implementation in
developing countries be-
came focused on four vertical programs: growth monitoring,
oral rehydration ther-
apy, breastfeeding, and immunization (GOBI). Family planning,
female education,
and food supplementation (FFF) were added later. These
interventions targeted
only women of childbearing age (15–45) and children through
7. age five. This narrow
selection of specific conditions for these population groups was
designed to im-
prove health statistics, but it abandoned Alma Ata’s focus on
social equity and health
systems development. This transformation from the lofty goals
set at Alma Ata to a
selective approach sparked more than two decades of exhaustive
debate.
Effectiveness Of Comprehensive Primary Health Care
Some global health analysts argue that comprehensive primary
health care was
an experiment that failed; others contend that it was never truly
tested. With only
one year between the Alma Ata declaration and the shift toward
a selective ap-
proach to its implementation, the transformative potential of
comprehensive pri-
mary health care remained largely unexploited. Nevertheless,
there were some im-
portant successes, particularly in the 1980s. Mozambique, Cuba,
and Nicaragua,
for example, expanded their primary health care coverage and
greatly improved
their population health indices.14 The keys to these
accomplishments were the po-
litical will to meet all citizens’ basic health needs, active
popular participation in
the effort to realize this goal, and increased social and economic
equity.15
C o m p r e h e n s i v e C a r e
H E A L T H A F F A I R S ~ V o l u m e 2 3 , N u m b e r 3 1 6
8. 9
“Some argue that comprehensive primary health care was an
experiment that failed; others contend that it was never truly
tested.”
Whereas the progress in Mozambique and Nicaragua was short-
lived, Cuba
has maintained steady progress even after the collapse of, and
loss of support from,
the Soviet Union and many years of embargo by the United
States.16 Its success has
been attributed to its model primary health care system.17
Under the Cuban con-
stitution, health care is a right of citizens and a responsibility of
government. In
addition, Cuba’s Public Health Law outlines the principles of
the National
Healthcare System as follows: socialized medicine organized by
government; ba-
sic services accessible to the whole population and free to all;
preventive medicine
as the hallmark of the system; public participation in health
care; and a compre-
hensive approach to planned development of the health system.
A 1997 report from
the American Association for World Health, analyzing the U.S.
embargo’s effects
on health in Cuba, concluded that a humanitarian catastrophe
had been averted
because the country maintained a high level of budgetary
support for a health care
system designed to deliver primary and preventive health care
to all of its citi-
9. zens.18 Cuba’s population health indices are on a par with those
of developed coun-
tries that have several times its budget: Life expectancy is
seventy-seven years, and
the infant mortality rate is 7.7 per 1,000 live births, which ranks
Cuba among the
twenty-five countries in the world with the lowest infant
mortality rates. As
Cesar Chelala observed, Cuba’s infant mortality rate for 1997
was half that of
Washington, D.C.19
Effectiveness Of Selective Primary Health Care
While many factors ultimately affected the implementation of
primary health
care by national governments and aid agencies, selective
primary health care and
the resulting programs that were and are supported cannot fulfill
the ideals of
Alma Ata, including the emphasis on self-reliance, which is
essential for commu-
nities to promote and sustain their own health.
� Shortcomings. First, the selective approach ignores the
broader context of de-
velopment and the values that are imbued in the equitable
development of countries.
It does not address health as more than the absence of disease;
as a state of well-
being, including dignity; and as embodying the ability to be a
functioning member of
society. In conjunction with the lack of a development context,
the selective model
does not acknowledge the role of social equity and social justice
for the recipients of
10. technologically driven medical interventions. The reality of the
model is that vertical
programs are centered in urban hospitals and health care
facilities. Without the par-
ticipation of communities, there is no avenue for change.
Second, the donor-driven, technocratic approach to determining
priorities for
interventions detracts from the grassroots approach that the
Alma Ata declaration
stated was necessary for health development. Third, the model
tends to preserve
the status quo of vertical objectives, fighting one disease at a
time and not incorpo-
rating these efforts into a higher baseline of health status.
Fourth, there is little coordination among these vertical
programs, leading to re-
1 7 0 M a y / J u n e 2 0 0 4
A g r e e m e n t s
dundancy, overlap, and waste. Finally, the sole emphasis on
women and young
children, to the neglect of other segments of the population, is
an important flaw.
The high burden of HIV/AIDS among people ages 20–39 in
many developing coun-
tries (an indication of infection during adolescence) is not
surprising, given the
long neglect of this population group in health policy and
practice.20
11. � Improvements and deficits in global health. In spite of the
above shortcom-
ings, selective primary health care has been lauded as having
contributed greatly to
improvements in global health. It is said, for example, that eight
of every ten children
in the world today receive vaccinations against the five major
childhood diseases.21
Globally, between 1980 and 1993 infant mortality fell by 25
percent, while overall life
expectancy increased by more than four years, to sixty-five
years.
However, whereas the number of children under age five who
died from vac-
cine-preventable diseases decreased by 1.3 million between
1985 and 1993, more
than twelve million of these children died within this period
nevertheless. Of this
figure, vaccine-preventable diseases still accounted for 2.4
million deaths. More-
over, childhood diarrhea and malnutrition remain leading causes
of impaired child
health in developing countries, contributing greatly to the
thirteen million deaths
that occur annually among children under age five.22
A 2003 United Nations report argues that international
assistance aimed at
helping poorer countries develop is failing; it calls for a
reexamination of current
strategies if the world is to meet targets for reducing poverty,
hunger, and illness.23
According to the report, fifty-four countries are poorer now
12. than they were in
1990, and life expectancy has regressed in thirty-four countries,
mostly in Africa.
Lessons For Future Global Health Policy
Although disease-specific interventions are important, assuring
real change
will require attention to environmental, political, and social
actions that target
the root causes of disease as envisaged at Alma Ata. Alma Ata’s
comprehensive pri-
mary health care was a global recognition of some of the causes
of unsatisfactory
results in many programs.24 Studies during the 1970s revealed
that lack of overall
development was inextricably linked to health and that health
discussed in a vac-
uum would never succeed. However, experimentation with
comprehensive and
selective approaches to global health policy have also revealed
that discussion of
health in the context of society, economics, politics, and
development put many
barriers in the way of success as well.
One of the ideological barriers was the concomitant challenge
of social equity
and social justice. Alma Ata made it the responsibility of
governments and agen-
cies to promote equity and ensure that certain citizens were not
unduly suffering
for the benefits received by others. Comprehensive primary
health care combined
many complex features into its definition of health and health
care.
13. � Various sectors need to work together. First, because health
does not occur
in isolation, the various sectors, including those within a
national government and
C o m p r e h e n s i v e C a r e
H E A L T H A F F A I R S ~ V o l u m e 2 3 , N u m b e r 3 1 7
1
among aid agencies, need to work together at every level of
practice. The ministry of
health is not the sole agency charged with production of health;
departments of agri-
culture, housing, sanitation, and education, along with food
distribution, are all in-
volved in achieving health.
� Interventions must come from needs of the community.
Second, the Alma
Ata declaration requires that interventions come from the needs
of the community,
expressed and subsequently led by community members. Global
health problems
cannot be solved by distant policymakers and planners.25
Involvement of individuals
and communities mobilizes local resources to deal with health
problems.26 Implied
in the concept of participation is decentralized physical
location; programs need to
be founded and researched in the locality in which they will be
applied. The Alma
Ata declaration also recognizes that the issue of accessibility to
14. health services and
resources has historically been a barrier to effective care and
that placing emphasis
on curative, tertiary care hospitals located in urban centers
often precludes access
for a mostly rural population.
� Fullest potential difficult to achieve without supporting
infrastructure.
These are some of the underpinning principles behind the Alma
Ata declaration; un-
fortunately, key elements are lacking in the selective approach
adopted for its imple-
mentation. Some developing countries continue to rely on
vertical programs, with
less emphasis on people’s involvement and development of
systems and infrastruc-
tures to sustain those programs. For example, although the
current initiative on vac-
cines and immunization designed to help countries incorporate
new vaccines into
their national health systems surely has benefits for addressing
specific communica-
ble diseases, their fullest potential will be difficult to achieve in
the absence of effec-
tive health systems and supporting infrastructures. Limited
assessment of this ini-
tiative undertaken in Mozambique, Ghana, Lesotho, and
Tanzania revealed that the
infrastructural foundation needed for successful implementation
and sustainability
is inadequate.27
Maintaining the cost of expensive new vaccines after donor
support ceases also
poses a serious challenge to sustainability. As with most
15. vertical programs, ana-
lysts have expressed concern that raising poor countries’
awareness of new vac-
cines and immunization programs without support in
implementing such pro-
grams could end up creating markets for these vaccines while
doing little to tackle
major health problems.28
Given that disease-focused models continue to be funded and
promoted in de-
veloping countries, it is apparent that adequate lessons have not
been learned
from experimentation with selective, vertical approaches; that
the notion of self-
reliance, community participation, and health systems
development proposed at
1 7 2 M a y / J u n e 2 0 0 4
A g r e e m e n t s
“Systems characterized by the absence of democracy and by
corruption are breeding grounds for inequities in health.”
Alma Ata have diminished in importance; and that inadequate
consideration is
given to the link between health and socioeconomic
development. Global health
policy for the twenty-first century should recognize that high-
tech and expensive
models to address diseases of poverty will not be sustainable
where infrastruc-
tures needed for operationalization and institutionalization of
16. those technologies
scarcely exist.
Revitalizing Alma Ata’s Tenets
Although the challenges of addressing the socioeconomic root
causes of disease
in developing countries may seem insurmountable, analyses of
factors that con-
tributed to health improvements in developed countries provide
cause for opti-
mism. For example, the appalling health conditions described in
the Report of the
Sanitary Commission of Massachusetts to the Massachusetts
state legislature in 1850
were similar to those that prevail in developing countries
today.29 The recommen-
dations embodied the essential elements of comprehensive
primary health care—
communicable disease control, promotion of child health,
housing improvement,
sanitation, training of community health workers, public health
education, pro-
motion of individual responsibility for one’s own health,
mobilization of commu-
nity participation through sanitary associations, and creation of
multidisciplinary
boards of health to assess needs and plan programs.
Recognizing the importance
of political commitment, the report called for establishment of a
strong public
health constituency and addressed inequity by highlighting
major differences in
life expectancies between U.S. rural and urban areas. Thus,
many of the improve-
ments in Americans’ health have been attributed to the ensuing
17. political commit-
ment and emphasis on public health and to social and economic
interventions.
Similarly, in reviewing factors that contributed to improvements
in health in
England, Thomas McKeown demonstrated that population health
improved more
because of investments in “environmental public health,”
political, economic, and
social measures than from specific medical or therapeutic
interventions.30 Decline
in deaths from tuberculosis and from respiratory and water- and
foodborne dis-
eases had already occurred before any effective immunizations
or treatments were
available.
� Concrete strategies and processes. Thus, to improve the
health status of
people in developing countries and to ensure sustainability, a
revitalization of the
tenets of Alma Ata’s primary health care is needed. Of critical
importance is the need
to establish concrete strategies and processes, with clear targets,
to reduce inequi-
ties in the allocation of resources for primary health care, and
with a focus on both
horizontal and vertical equity.31 The value of this proposal is
illustrated by the strik-
ing success that has been achieved in social development and
health by a few poor
countries, notably Sri Lanka, Costa Rica, Cuba, China, and
Kerala state in India.
Mortality and malnutrition rates are much lower and life
expectancy much higher
18. in these countries than in other countries with similar economic
characteristics and
C o m p r e h e n s i v e C a r e
H E A L T H A F F A I R S ~ V o l u m e 2 3 , N u m b e r 3 1 7
3
indeed some wealthier countries. In this regard, it is important
to stress that the na-
ture of the political system, its values, and its processes for
participation define the
frontiers of opportunity for health equity.32 Systems
characterized by the absence of
democracy and by pervasive corruption, violence, and sex
discrimination are breed-
ing grounds for inequities in health and in other social spheres.
� Social policies. Health policymakers should be aware that
macroeconomic,
labor, and social policies have the potential to limit or enhance
health opportunities
for different groups in the population. International aid agencies
and governments
in developing countries should be aware that the pursuit of
liberal macroeconomic
progrowth policies has the tendency to provide better
opportunities to those with
resources and high levels of education while large segments of
the population with-
out these assets are unlikely to benefit and may in fact become
casualties of eco-
nomic transition. Thus, it is the duty of health policymakers to
signal when other
19. policies may undermine efforts to promote health equity.33
� Intersectoral forums. Countries also need to strengthen their
primary health
care through the development of intersectoral forums at every
level. Human health
should be a cross-cutting issue throughout the decision-making
process in different
sectors and at different levels. Health policy development
should involve those sec-
tors, agencies, and social groups that are critical to achieving
better health. This can
be achieved through advocacy for health objectives as integral
to socioeconomic de-
velopment and through engagement of different sectoral
partners and community
structures in the consensual process.
� Funding commitment. Developing countries’ governments
must be commit-
ted to funding and budgets for sustaining community
involvement in health. This
can be achieved through, for example, private-sector
involvement and through host-
ing village, district, or regional people’s health assemblies so
that the voices and
opinions of the people can be represented in the design and
implementation of
health policies.
� Trained health personnel. Most importantly, to ensure the
quality of primary
health care, reform of the health sector under primary health
care should include co-
herent human resource development plans at the village,
district, state/regional, and
20. national levels and strategies for retention of trained personnel
in remote and rural
areas. Primary health care systems in developing countries
provide interventions
that are already known to be effective. This means that
achievement of quality in
primary health care facilities requires the proper performance of
these interventions
according to prescribed standards to reduce mortality,
morbidity, and disability.
However, the most common challenge is that often these
interventions are not prop-
erly executed.34 A recent study in southeast Nigeria, for
example, revealed that inad-
equacy in the quality of services provided by community-based
primary health care
workers is a product of failures in a range of quality measures:
structural, process
failings, and lack of a protocol for systematic supervision of
health workers.35 Thus,
quality improvement in this context is not simply a matter of
providing infra-
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A g r e e m e n t s
structural resources but, rather, one of paying attention to
improvement in process,
especially through training and supervision.
� Long-term social interventions. Finally, although short-term
measures do
not necessarily undermine the contributions of vertical
21. therapeutic interventions to
public health, it is apparent, as this paper has shown, that they
are not sufficient to
greatly alleviate the overall burden of disease in developing
countries unless the so-
cioeconomic, political, and health system factors that underpin
health and disease in
these countries are challenged. The remedy, as we have argued,
lies in a fundamental
shift in emphasis from vertical, short-term measures to a
revitalization of Alma Ata’s
primary health care, with emphasis on poverty alleviation,
community participa-
tion, and the development of health systems and infrastructures
to create and sus-
tain health.
NOTES
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