The transfer of planning theories to health planning practice

Improvement is required in the theoretical bases of health planning in order for needed advances to occur in health planning practice. Four major planning strategies are utilized in other public policy sectors: the rational, the incremental, the mixed scanning and the radical strategies. All four strategies are potentially useful in health planning and their impact is suggested in a health planning situation.     

Social indicators for health planning and policy analysis

The concept of health involves two dimensions: The level of function at a point in time and the probability of transition to other levels at future times. By applying measured social values to the distribution of the population among a set of levels, a Function Status Index aptly summarizes the Level-of-Well-Being of a population at a point in time. By incorporating empirically determined transition probabilities into a simple stochastic model, a Quality-Adjusted Life Expectancy can be computed that approximates a comprehensive social indicator for health. The indicators possess the statistical properties required for time series and interpopulation comparisons, for studying outcomes and quality of medical care, and for health system optimization in planning and policy analysis.     

Can ministries of health support primary health care? Some suggestions for structural reorganization and planning

Patrick Vaughan is Reader in health care epidemiology, Gill Walt is Lecturer in health policy and Anne Mills is Lecturer in health economics, at the Evaluation and Planning Centre for Health Care, London School of Hygiene and Tropical Medicine, Gower Street, London WC1, United Kingdom. A previous version of this paper was prepared for the Commonwealth Secretariat, London, for the Conference of Commonwealth Health Ministers held in Ottawa, Canada, in October 1983.     

The need for centres of health research excellence in the developing world

Pervasive ill health and overpopulation impede progress in most developing countries but in recent years, programs providing aid to these regions have de-emphasized health as a priority. Furthermore, support for building the health research capacity, so essential to the success of efforts to promote improved health, has been lacking. This paper examines these policies as they relate to one developing country, one global h ealth program and a major Canadian development agency. Much has been achieved in the past decade in one of the world's poorest countries, Bangladesh, but major health problems persist, particularly in maternal and child health. With the will to build effective health programs, Bangladesh lacks the resources and the research base needed for their development. The World Health Organization, (WHO) Diarrhoeal Disease Control (CDD) program, which addresses a major cause of child mortality in Bangladesh, promotes effective treatment but it contributes little to a permanent research establishment in that country. The Canadian International Development Agency (CIDA) which directs only a small portion of its $2.2 billion annual budget to health, lacks an influential level of technical expertise in health. This agency has no mandate to support health research in the developing world; research is the responsibility of the International Development Research Centre (IDRC), the Health Sciences Division of which closed in July, 1995. To upgrade the place of health and health research in development, the attitudes and policies of major donors must change and models of success are needed. Of the existing institutions or programs involved in health and health research in the developing world, the internationally funded health research centre, strategically sited in the developing world could provide the excellence around which relevant programs should flourish. An existing example of this rare species, the International Centre for Diarrhoeal Disease Research, Bangladesh, merits particular consideration in this regard.     

Macron and the world

Newly elected French President Emmanuel Macron, while inexperienced in international affairs, is inclined to return France to a de Gaulle/Mitterand tradition of national assertiveness. At the same time, his native prudence, as well as the geostrategic realities of the early twenty-first century, suggest more continuity than change.     

Restructuring family planning in the health service: the case of young people's clinics

A review of the experience of adolescent reproductive health clinics in Liverpool and Bristol highlights the potentially disruptive impact of new National Health Service (NHS) policies and competing professional interests on the attempt to provide integrated, high-quality services. In particular, responsiveness to client needs often collides with NHS demands for efficiency. UK health authorities accept, in principle, the need for separate, informal family planning centers for young people. The 34 Brook Advisory Centers, which deliver confidential contraceptive and counseling services to adolescents, face pressure to become population rather than client-based and to reduce time spent on individual sessions. Moreover, new NHS contracting arrangements have greatly increased the role of general practitioners (GPs) in contraceptive provision, with serious implications for family planning clinics. At present, about 70% of UK women obtain contraceptive and sexual health services from a GP. This encroachment has further increased the marginalization of family planning practitioners, the majority of whom are female, within the medical profession. Concerns have been expressed, however, that GPs are not able to offer the comprehensive services available in clinics and lack sufficient female staff.     

World energy demand and world security

Global oil production is expected to reach a peak before the year 1990. Abundant coal supplies in the United States appear to be something of a mixed blessing, due to the increasingly well-recognized social and environmental problems from mining and burning coal. Nuclear power turns out to be more expensive than it appeared a decade ago, in part because of the formidable safety and environmental hazards posed. Given that supplies of energy are very unevenly distributed across the globe, if energy prices continue to rise over the next decade the potential for violent international conflict is very real. It should therefore be useful to review what is known about world energy supply and demand, and to consider some implications for energy research and development in the United States and abroad. I shall suggest that for various reasons solar energy may look even more attractive in global perspective than it does from a more narrowly United States-centered view. Its successful exploitation on a world scale nevertheless requires careful attention to foreign countries' goals and constraints.This article stems from a presentation to the Mapping Group on Energy and the Social Sciences at the Institution for Social and Policy Studies, Yale University. I am much indebted to the German Marshall Fund for financial support, and to Peter Allison, Thomas Biersteker, Stanley Black, Leonard Doob, William Freudenberg, Leroy Gould, John Hendricks, Guy Orcutt, William Reifsnyder, Brian Skinner, Jan Stolwijk, and Charles Walker for comments and suggestions. Responsibility is of course my own.     

Financial planning and control systems

This article surveys essential concepts and elements of New Zealand's state sector reforms, focusing on: the guiding philosophy—transparency and consistency; operating principles—the distinction between outputs and outcomes, purchaser and provider, government and departments, the principal instruments—purchase agreements between ministers and chief executives, delegation, performance measures. (© 1997 by John Wiley & Sons, Ltd.)