Lecture 11: Chapter 13

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Lecture 11 Chapter 13 Toward Healthy Societies: From Ideas to Action
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- Hookworm vs. Malaria (pre WWII) t shoe wearing, swamp draining, mosquito nets etc.
o Sanitary + Technical approaches
- Promise/Perils of technical approaches t pure technical
- Smallpox: did the end justify the means?
Table 13.1: Cost of Smallpox Eradication Program
Child Survival Campaigns p659-60
- 1982 onwards: GOBI-FFF (Growth Monitoring, Oral-Rehydration Therapy, Breast Feeding,
Immunization t family planning, female education, food supplementation)
- Throwback to technically-based disease campaigns
- Effective if narrowly defined but underlying conditions not addressed: malnutrition, lack of
sanitation
o Most of IMR decline pre-dated child survival
- Vertical rather than community-based approaches
Individualistic behavior-change p660
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Which Selective Interventions Work and What is the Evidence p661
- Millions Saved: Proven Successes in Global Health
1) Predictable and adequate funding from both local and international sources
2) Political leadership and champions
3) Affordable technological innovation within an effective delivery system
4) Technical consensus about the appropriate biomedical or public health approach
5) Effective management of heath delivery systems
6) Effective use of information
EX: Sri Lanka t Yet only part of evidence examined
Limitations of Single Disease Campaigns p664-5
- Why did Global Malaria Eradication fail?
- Vertical campaign weakness
o More emphasis on biological than infrastructural
o Health system distortions (loss of PHC)
o No health system can be built on vertical campaigns yet IH emphasizes these
- Isolation focus on technical aspects inflated mortality balloon elsewhere
Healthy Societies: Case Studies p666-7
- Countries with political parties in power subscribing to social democratic principles have better
health outcomes
- Why?
- Who tries the hardest to reduce inequities?
- What enables welfare state successes in developing countries?
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