Italian Non-governmental Organization Research Articles

The Knud Jansen Lecture. A personal view of prosthetics and orthotics.

It is a great honour for me to present the Knud Jansen Lecture. I will not present results of studies and research here, but I hope that I will be able to share some of my personal views and experiences and present some particular considerations. I am a medical doctor. After having taken my degree, I specialised in paediatrics and decided to spend some years in developing countries in order to offer my services in places where specialised medical doctors were practically unknown. I worked as a volunteer for 6 years in remote rural areas of Uganda and Kenya. I learnt a lot about the conditions of people in this part of the world. I touched by hand what it means to be in a hospital with insufficient qualified staff, without proper drugs, and how difficult it is to remain up-to-date with the developments in your profession under such conditions. After the period in Africa, I again joined the university. After specialising in child neurology and psychiatry, I became head of a children's rehabilitation department in Italy. All this time, my interest in developing countries remained very strong and when I was requested by an Italian non-governmental organization (NGO) to make short voluntary consultancy missions for them in the leprosy field, I immediately accepted this. In this capacity I visited many developing countries, especially in Africa and Asia. It also gave me the opportunity to see many orthopaedic workshops, where shoes and prostheses for persons with leprosy were produced. Many of you know how a workshop in a developing country may look like. On my visits, I met with the persons in charge of the workshop

Strengthening local health care management in Bolivian districts through participatory operational research.

The purpose of this article is to demonstrate how the use of a participatory health care management and problem-related research methodology may help strengthen health service management and the capacities of local health care personnel. The text refers to five studies carried out in three Bolivian health districts from 1993-1995, in an Operational Research Project, conducted by an Italian N.G.O. (Cooperazione Internazionale) in agreement with the local Ministry of Health and P.A.H.O./W.H.O. The object of these studies was to assess the main problems in health care delivery and to define and implement appropriate solutions. The studies utilized a methodology based on the principles of operational research and continuous quality improvement. During the process some positive aspects and difficulties were met. The positive aspects were: the applied character of the research focused on the solution of a problem; the study of a problem related to health service management; the use of modern and simple techniques adapted to local knowledge; on-the-job training of health care personnel during the research process. Lack of a generic 'culture of research' and poor health personnel training were the main difficulties encountered. National health authorities should take these points into account to define or readjust policies on health service research, health workers' academic education and in-service training. Insisting on developing human resources and allowing them to achieve and expand their potential is the key factor for getting developing countries out of their current crisis and toward reaching a truly human and sustainable development.