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Integrating oral health into primary health care - experiences in Bangladesh, Indonesia, Nepal and Tanzania

INTERNATIONAL DENTAL JOURNAL 1999年第4期49卷 240-248页

作者： Helderman, WV Mikx, F Begum, A Adyatmaka, A Bajracharya, M Kikwilu, E Rugarabamu, P Nijmegen The Netherlands Dhaka Bangladesh Jakarta Indonesia Kathmandu Nepal Dar es Salaam Tanzania [*]WHO Collaborating Centre Dentistry 117 Postbus 9101 6500 HB Nijmegen The Netherlands

When primary health care (PHC) was developed and implemented in developing countries, oral health was not included. The present consequences are marked disparities in the distribution of oral health care, since conventional dentistry can only serve relatively few people and at high costs. Oral health care is virtually non-existent in rural areas of most developing countries where more than 80 per cent of the population live. More recently, community based oral health programmes have been initiated in some countries to fill the gap. These programmes give more emphasis on oral health promotion and on the prevention of oral diseases than on treatment of its consequences, since history has shown that the latter is ineffective in preventing oral diseases. Unfortunately, most of these oral health programmes have been implemented next to the existing PHC system and hence they face enormous management, logistic and financial problems, which seriously threaten their sustainability. This paper presents a proposal to counteract the problems that many countries face in developing an adequate primary oral health care (POHC) service.

关键词：孟加拉国社区卫生服务/组织和管理卫生保健提供联合牙科医疗/分类牙科医疗/经济学牙科医疗/组织和管理牙科保健服务/组织和管理发展中国家/经济学财政支持健康教育牙科健康计划健康促进卫生资源/经济学卫生资源/组织和管理卫生服务易得程度/组织和管理印度尼西亚口腔疾病/预防和控制国家卫生规划/组织和管理尼泊尔口腔保健初级卫生保健/经济学初级卫生保健/组织和管理乡村卫生服务/组织和管理坦桑尼亚人类

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Dentistry in Taiwan, Republic of China: national health insurance reforms, illegal dentistry and plans for peer review quality control

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INTERNATIONAL DENTAL JOURNAL 1999年第2期49卷 76-81页

作者： Moore, R Shiau, YY Aarhus Univ Royal Dent Coll Dept Oral Epidemiol & Publ Hlth DK-8000 Aarhus C Denmark

The dental health care system in Taiwan, Republic of China is described in terms of demographics, structure, context of treatment and historical development of the dental health care payment system. A notable characteristic of the system is the existence of trade dentists, who operate without licensure. Their popularity and price advantage has maintained a political base that affects policy decisions. Health care reforms of March, 1995 with a comprehensive national health insurance, as well as ambitious plans for systematic peer review quality control of dentists' work are unique health care developments worthy of the attention of health care polity makers in other countries who are studying health care reform processes.

关键词：费用牙科卫生保健改革/组织和管理卫生政策保险牙科/立法和法学立法牙科许可证牙科/立法和法学国家卫生规划/组织和管理同行评议卫生保健政策制订专业业务质量控制台湾女(雌)性人类男(雄)性

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The Spanish health care system:: lessons for newly industrialized countries

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HEALTH POLICY AND PLANNING 1999年第2期14卷 164-173页

作者： Rodríguez, E De Puelles, PG Jovell, AJ Cornell Univ Dept Policy Anal & Management Ithaca NY 14853 USA Catalan Hlth Serv Catalan Agcy Hlth Technol Assessment Dept Hlth & Social Secur Barcelona Spain

This article summarizes the organization, financing, and delivery of health care services in Spain, and discusses the elements that made it possible to maintain high levels of health among the population, while spending comparatively fewer resources on the health care system than most industrialized countries. The case of Spain is of particular interest for newly industrialized countries, because of the fast evolution that it has undergone in recent years. Considered, by United Nations' economic standards, a developing country until 1964, Spain became in a few years the fastest growing economy in the world after Japan. By the early 1970s the infant mortality rate was already lower than in Britain or the United States.

关键词：卫生保健提供/经济学卫生保健提供/组织和管理发达国家效率组织筹资政府卫生保健公平提供卫生经费支出卫生人力健康状况指标医院公立/组织和管理国家卫生规划/经济学国家卫生规划/组织和管理初级卫生保健/组织和管理公共卫生管理社会正义西班牙/流行病学世界卫生

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IMPROVING HEALTH-CARE PLANNING - SOME LESSONS FROM IMMUNIZATION

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LONG RANGE PLANNING 1984年第5期17卷 88-95页

作者： FOTTLER, MD Professor Management and Director Ph.D. Program in Administration University of Alabama

This article presents a managerial perspective on health planning by the Federal Government illustrated by the case of the Swine Flu Immunization Program. The recent national program in the U.S.A. for immunizing the entire population against the swine flu is examined in terms of the processes of health planning. It is concluded that this program was poorly planned and therefore doomed to failure from the beginning. Recommendations for improved planning of similar programs are made.

关键词：健康计划/方法免疫法流感病毒A型/免疫学国家卫生规划/组织和管理美国人类

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Personal Dental Services - a practitioner's point of view

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BRITISH DENTAL JOURNAL 2000年第3期188卷 125-128页

作者： Barker, N Dixon, H Bromley Rd Dent Surg Colchester CO4 3JE Essex England

NHS dentistry has seen many changes recently. the latest has been the introduction of Personal Dental Services. This article describes the experiences of two general dental practitioners in their practice who entered as a first wave pilot, the article explains the steps involved in generating a proposal and preparing a practice to run as a pilot. The authors have highlighted areas of particular concern for others to consider before embarking on a similar journey.

关键词：成本及成本分析国家卫生规划/经济学国家卫生规划/组织和管理个人保健服务/经济学个人保健服务/组织和管理试点项目偿还途径/经济学偿还途径/组织和管理公费牙科医疗/经济学公费牙科医疗/组织和管理人类

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Germany's long-term-care insurance: Putting a social insurance model into practice

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MILBANK QUARTERLY 2000年第3期78卷 375-+页

作者： Geraedts, M Heller, GV Harrington, CA Univ Calif San Francisco Dept Social & Behav Sci Sch Nursing San Francisco CA 94118 USA Univ Dusseldorf D-4000 Dusseldorf Germany

A growing population of elderly has intensified the demand for long-term care (LTC) services. In response to the mounting need, Germany put into effect a LTC Insurance Act in 1995 that introduced mandatory public or private LTC insurance for the entire population of 82 million. The program was based on the organizational principles that define the German social insurance system. Those individuals in the public system and their employers each pay contributions equal to 0.85 percent of each employee's gross wages or salary. Ten percent of the population with the highest incomes have chosen the option of purchasing private long term care insurance. Provisions were made for uniform eligibility criteria, benefits based on level of care needs, cost containment, and quality assurance. Over the first four years of its operation, the system has proved financially sound and has expanded access to organized LTC services. The German system thus may serve as an example for other countries that are planning to initiate social LTC insurance systems in other nations.

关键词：德国保险长期医疗/经济学保险长期医疗/立法和法学国家卫生规划/经济学国家卫生规划/立法和法学国家卫生规划/组织和管理方案评价社会保障/经济学社会保障/立法和法学社会保障/组织和管理全民健康保险老年人人类中年人

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The Nepal National Vitamin A Program: prototype to emulate or donor enclave?

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HEALTH POLICY AND PLANNING 2000年第2期15卷 145-156页

作者： Fiedler, JL Social Sectors Dev Strategies Sturgeon Bay WI 54235 USA

More than 250 million of the world's children suffer from vitamin A deficiency. Nepal is one of 60 countries in which this deficiency constitutes a significant public health problem. Each year in Nepal, vitamin A deficiency is responsible for the deaths of 9000 children and for 2500 children becoming permanently blind. The Nepal National Vitamin A Program (NVAP) was begun in 1993 in eight of the country's 75 districts. By the end of 1997, the programme covered 32 districts, and by 2003 its coverage will be nationwide. The Nepal NVAP is considered by many to be a highly successful, model programme. It consists primarily of distributing high-dose vitamin A capsules to all children 6 to 60 months of age during twice-yearly campaigns. The capsule distribution is carried out by a previously existing network of Female Community Health Volunteers (FCHVs) that has been reinvigorated by the highly visible and universally acclaimed success of the NVAP. An important strategy of the programme has been the empowerment of the FCHVs, which has been accomplished by organizing, training and motivating community workers and other representatives from education, agriculture and other sectors, as well as political representatives, to support the FCHVs. The annual cost of the NVAP is US$1.7 million. It costs $1.25 to deliver two vitamin A capsules to each participant. The cost per averted death is $327. The NVAP reduces the incidence and severity of diarrhoeal disease and measles, which in turn reduces the need for Ministry of Health services, thereby annually saving the Government of Nepal $1.5 million. Factoring in these cost savings, the net annual cost of the current NVAP is $167 000, and the net annual cost of the permanent, nationwide programme is estimated at $1.1 million. The NVAP is a highly cost-effective programme. The article concludes with a discussion of the sustainability and replicability of the programme.

关键词：盲/预防和控制卫生保健费用/统计学和数值数据健康促进/经济学健康促进/组织和管理国家卫生规划/组织和管理尼泊尔/流行病学公共卫生维生素A/投药和剂量维生素A缺乏/流行病学维生素A缺乏/预防和控制儿童儿童学龄前女(雌)性人类婴儿

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NHS laboratories can provide a service to the pharmaceutical industry: a personal experience

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ANNALS OF CLINICAL BIOCHEMISTRY 2000年第6期37卷 751-757页

作者： Love, ER Eve, MD Rose, R Lamb, EJ Prizer Clin Res Unit Canterbury CT13 9NJ Kent England Kent & Canterbury Hosp Pathol Directorate Canterbury CT13 9NJ Kent England

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STRATEGIES TO CONTROL INFECTIONS IN MALNOURISHED POPULATIONS - HOLISTIC APPROACH OR NARROWLY TARGETED INTERVENTIONS

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AMERICAN JOURNAL OF CLINICAL NUTRITION 1978年第12期31卷 2292-2300页

作者： LATHAM, MC Professor of International Nutrition and Director Program in International Nutrition.

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The progress of the Polio Eradication Initiative: what prospects for eradicating measles?

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HEALTH POLICY AND PLANNING 1998年第3期13卷 212-233页

作者： Gounder, C Johns Hopkins Univ Sch Hyg & Publ Hlth Baltimore MD 21205 USA

Although various attempts have been made to eradicate infectious diseases, only smallpox has been eradicated to date. Polio is targeted for eradication in 2000 and already planning has begun for the eradication of measles. However, before we commit to a measles eradication effort, we must examine the lessons to be learned from polio eradication. Of particular importance is the debate over whether resources should be invested in 'horizontal' or 'vertical' programmes. The outcome of these debates will have a very deep and lasting impact on global health development in years to come. Collaboration between targeted programmes and the primary health care sector through polio and measles eradication efforts will help bring about the necessary balance between goal-oriented programmes, which are subject to quality control and can be evaluated by measurable outcomes, and broader efforts to build up sustainable health infrastructure.

关键词：传染病控制/组织和管理发展中国家龙线虫病/预防和控制卫生保健公平提供免疫接种规划疟疾/预防和控制麻疹/预防和控制国家卫生规划/组织和管理脊髓灰质炎/预防和控制方案评价天花/预防和控制美国世界卫生人类

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