Chapter 13 Notes

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IDSB04 - Ch.13
Disease control’ as international health
Smallpox eradication
Malaria eradication failed
Lessons learned plus favorable conditions helped in smallpox eradication effort
o Long experience with smallpox control
o Lack of non-human animal host
o Availability of effective vaccine
o Global campaign strategically divided into tree comprehensive phases: attack, consolidation,
o Despite limited financial support, plenty of institutional and scientific support, but
Very expensive for developing countries (although savings after eradication)
Issues of coercion and divisions over approach and type of vaccine used
What about other health issues that may have been more pressing?
Child survival campaigns
UNICEF proposed to vanquish common infections of early childhood using simple medical
GOBI: Growth monitoring, Oral hydration therapy, breast feeding, and immunization against six
childhood diseases (TB< diphtheria, whooping cough, tetanus, polio, and measles)
GOBI-FFF: Above plus family planning, female education, and food supplementation
Limitation included:
o Ritualistic growth monitoring w/o addressing reason for poor nutrition
o Oral rehydration w/o addressing reason for childhood diarrhea
o Centrally controlled, top-down immunization programs
o Limited focus on individual behavior change
Outcomes: reduced child mortality? - not really child mortality declines started well b4 the start
of UNICEFs child survival campaign
Box 13-1 *Scaling Up:
taking a proj from pilot to broad application.
o a program is tested out in a local district and when the obstacles are ironed out it is applied to an
entire province or country.
bottom up model
concept fails to take into account the larger societal envir in which programs are operating
term implies a narrow & precarious form of social service deliver.
-more politically contextualized metaphor might bebuilding stairs, bridges, & foundations
implying that the programs are protected, solid, & connected to the larger community (ex; a
national public social welfare sys)
**Limitations of the single disease campaigns
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