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Biomedical subjects

O Gish

Publications and source records attributed to O Gish.

At least 19 recordsLinked to original sources
PubMed1992

Malaria eradication and the selective approach to health care: some lessons from Ethiopia.

Analysis of the failure of the World Health Organization's global malaria campaign has contributed to the formulation of the primary health care concept as the basic international strategy for health improvement. The Primary Health Care Conference held in Alma-Ata in 1978 was to have ended the period of vertical disease control programs, such as the one against malaria, stressing instead the integration of these programs into horizontal community-based health systems. Malaria control programs, however, have not been integrated well--or in some cases at all--into primary health care networks. An analysis of the Ethiopian experience, as part of the worldwide malaria eradication program, illustrates the political and economic forces that have worked against the move from vertical to integrated malaria control activities, and from vertical to integrated health programs more generally.

Delivery of Health Care↗
PubMed1990

Some links between successful implementation of primary health care interventions and the overall utilization of health services.

All societies have need of a sick care system into which the general population has easy access. Such a system is required for the coherent organization of any health care service which is to be effective. Virtually all people want curative care when ill, but generally are less interested in preventive activities. It follows that a sick care service should be as widely available as it is hoped will be a preventive one. An effective sick service provides the basis of sufficiently regular contact with the bulk of the population so as to allow for the successful fulfillment of preventive health care goals. A shift is required from conventional input planning methods--more doctors, more health centers, etc.--to output planning; that is, actual utilization by the population of the services offered. The concern here is with the overall contact rate between the health service and the entire (relevant) population and not just the rate for any one particular health care program. Planning for additional inputs should be based on the expected outputs (contacts) which are expected to flow from those inputs. An average, well distributed annual utilization level of three to four contacts per capita should provide an adequate basis for fulfillment of preventive (and curative) goals in the health sector.

Developing Countries↗
PubMed1978

Alternative forms of transport and their use in the health services of developing countries.

During the past few years greater interest has been shown in ways in which the coverage of health services in developing countries might be increased. Frequently, it has been advocated that greater use be made of mobile health services, often using relatively sophisticated transport systems, including aircraft. The present article examines the uses to which mobility in health services has been put and the merits of different forms of transport, within the resource constraints and health "needs" of Third World countries. Our main conclusions are that for the majority of health service movement appropriate intermediate technology transport should be used (i.e. bicycle, animals, or motorcycles). The use of mechanical transport within health services with the highest benefit per unit cost is likely to be that employed in the regular supportive (not policing) visits to permanently staffed fixed basic care facilities by more highly skilled and scarce health personnel. Those clinics located closer to the regional base can usually be reached more cheaply by land transport, while those at a distance might justify the use of a light aircraft. Where aircraft are used in this supportive role, it is important they are integrated into the ongoing health services and tightly scheduled to lessen the risk of their diversion to less cost-effective activities.

Aircraft↗
PubMed1977

Mobile health services: a study in cost-effectiveness.

The techniques of cost-effectiveness are employed to simplify resource allocation decisions concerned with the use of land and air transport systems in the health services of a developing country. Outcome classifications are produced for patients seen by mobile and fixed primary care units. The mobile services examined were far more costly (8 to 14 times greater) per likely-effective-patient-contact than comparable care delivered from permanently staffed fixed clinics. This was particularly so for the air-delivered service. The disparity in cost-effectiveness was due mainly to the small proportion of patients seen by the mobile services who could be treated effectively in contrast to a far larger proportion at fixed clinics. This was a consequence of the periodic availability of care from the mobile services as against the continuing provision of care at fixed clinics. The main justification for the use of mechanical transport in connection with primary health care is regular supportive (not policing) visits by skilled health workers to rural clinics. Land vehicles are cheaper than aircraft for visiting the more accessible facilities; for the more distant clinics, the cost of journeys by land vehicle are similar to those by aircraft.

Aircraft↗
PubMed1977

Inequality in the distribution and differential utilization of health services: a Botswana case study.

The uneven provision of health care in a developing country, Botswana, is examined. Curative out-patient attendance and in-patient hospitalization rates were found to vary markedly for groups of the population living at different distances from health facilities. Those people living 10 miles or less from clinics and hospitals had far higher utilization rates than those living at further distances. If the disparity in service provision described is to be altered then the planning and development of health services should concentrate upon the provision of basic health care and adapt to the manpower and economic constraints within which such systems operate.

Botswana↗
PubMed1976

Medical brain drain revisited.

There is increasing pressure for the training of greater numbers of doctors. This pressure stems from the growing demand for higher education for the children of an expanding middle class, and from the desire to create more "satisfactory" doctor/population ratios. But, in fact, the middle classes produce doctors primarily to serve their own class. Since the training of doctors is geared to the values and requirements of those with money incomes sufficient to purchase private medical care, it is very expensive. These costs are such that the level of effective economic demand of most of the population cannot possibly meet the expectations and requirements of the medical graduates, who then "overflow" into those parts of the world where demand is greater than the current supply of doctors.

Asia↗