Many people in developing countries lack access to health technologies, even basic ones. Why do these problems in access persist? What can be done to improve access to good health technologies, especially for poor people in poor countries?This book answers those questions by developing a comprehensive analytical framework for access and examining six case studies to explain why some health technologies achieved more access than others. The technologies include praziquantel (for the treatment of schistosomiasis), hepatitis B vaccine, malaria rapid diagnostic tests, vaccine vial monitors for temperature exposure, the Norplant implant contraceptive, and female condoms.Based on research studies commissioned by the Bill & Melinda Gates Foundation to better understand the development, adoption, and uptake of health technologies in poor countries, the book concludes with specific lessons on strategies to improve access. These lessons will be of keen interest to students of health and development, public health professionals, and health technology developers—all who seek to improve access to health technologies in poor countries.
People are living longer, creating an unexpected boom in the elderly population. Longevity is increasing not only in wealthy countries but in developing nations as well. In response, many policy makers and scholars are preparing for a global crisis of aging. But for too long, Western experts have conceived of aging as a universal predicament—one that supposedly provokes the same welfare concerns in every context. In the twenty-first century, Kavita Sivaramakrishnan writes, we must embrace a new approach to the problem, one that prioritizes local agendas and values.As the World Ages is a history of how gerontologists, doctors, social scientists, and activists came to define the issue of global aging. Sivaramakrishnan shows that transnational organizations like the United Nations, private NGOs, and philanthropic foundations embraced programs that reflected prevailing Western ideas about development and modernization. The dominant paradigm often assumed that, because large-scale growth of an aging population happened first in the West, developing societies will experience the issues of aging in the same ways and on the same terms as their Western counterparts. But regional experts are beginning to question this one-size-fits-all model and have chosen instead to recast Western expertise in response to provincial conditions. Focusing on South Asia and Africa, Sivaramakrishnan shows how regional voices have argued for an approach that responds to local needs and concerns. The research presented in As the World Ages will help scholars, policy makers, and advocates appreciate the challenges of this recent shift in global demographics and find solutions sensitive to real life in diverse communities.
Throughout Africa, Asia, and Latin America public health professionals and paraprofessionals work to control serious, frequent and preventable causes of death and sickness among women and children. Despite international agreement about which health programs to implement and huge investments to support them, avoidable deaths remain high. One reason is the inadequate quality with which programs are implemented.Assessing Child Survival Programs in Developing Countries provides local health system managers with basic principles for rapid precise program monitoring and evaluation in difficult tropical conditions. Joseph Valadez explains how to adapt Lot Quality Assurance Sampling (LQAS) as used in industrial quality control more than half a century ago, to assess health program coverage and technical quality of service providers. He shows that by examining no more than 19 children from a health facility catchment area a manager can judge whether coverage with child survival interventions has reached a minimal level, and how to observe health workers perform a task 6 times to judge their technical competency.Joseph Valadez demonstrates that quick assessment is not necessarily dirty, and can provide the information needed to enhance child survival throughout the developing world. In that spirit Assessing Child Survival Programs in Developing Countries is a path breaking text book of modern health services research that both practitioners and students will find indispensable and understandable.
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