International Health Planning

Abstract

Scrimshawin a paper published in 1974 correctly emphasizes that socioeconomic development; of which improved health and nutrition standards are integral components can only be a holistic process. This axiom is now receiving the attention it deserves and there are repeated requests on the part of developing countries leaders and planners that technical assistance resources be not allocated disproportionately according to priorities demanded by Western experts. The focus of the last decades on a systems approach to planning should promote adequate consideration of the influence on nonhealth factors on health conditions and health services. Most of the ills of public health importance in developing countries are basically socioenvironmental in nature and the following are examples of major health problems in these countries: malnutrition decreasing practice of breast-feeding the effects of socioenvironmental conditions on communicable diseases anemia and health problems related to human reproduction. In that high fertility in developing countries is promoted by very high infant and child morality and since it is recognized that this excessive morality is overwhelmingly due to socioenvironmental factors the population problem itself is to a certian extent environmental in its causation. An obvious corollary of great importance is that health workers must be very knowledgeable about this environment. No matter how skilled health workers are they will not be of much help if there is a gap between them and those they are supposed to be serving. The real challenge in international health planning might well be the effective involvement of the community the bridging of the gap between the common person and the health services the government makes available. Additionally all planners should be wary of avoiding overplanning and underimplementing.