PubMed · 124925
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L Hogrefe. 1975. Family practice.. https://pubmed.ncbi.nlm.nih.gov/124925/
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The child-bearing events are normal physiological processes in the body of the woman and embryo-foetus/baby. Many changes in the internal and external environments of the family take place, simultaneously with these normal processes. These changes lead to the development of certain tasks and responsibilities that must be successfully accomplished by the family during the child-bearing events. Many changes have also taken place in midwifery during the last half of this century. These changes in midwifery practice, together with the changes that take place during child-bearing events, may cause the new family to feel insecure during this stage of their lives. Very often when the family comes into contact with the midwife the factors contributing to feelings of insecurity are present already or soon become present. Their insecurity causes the family to look to the midwife for help and support. The questions that arise are: What are the caring activities which the midwife should carry out to assist and facilitate the new family to grow on the health continuum during the postnatal period? How can the humanistic values of caring be combined with the scientific knowledge base that guides the midwife's actions to form the science of caring? A description of the midwife's caring functions during the post-natal period, in the hospital as well as in the community, is therefore essential. Thereafter, formulation of valid standards for postnatal care by the midwife can contribute to quality post-natal care in South Africa.
This paper presents a personal view of the development of integrated, comprehensive health-care systems in the United States. The influence of Federal legislation is described, beginning with the 1950-60s policy objective of Hill-Burton Program administrators to create a number of community-based regional medical centers, each consisting of a range of health services organized by and around community hospitals. Later variations of the concept appeared in such programs as Medicare-Medicaid, Comprehensive Health Planning, the Regional Medical Programs, and the new Agency for Health Care Policy and Research. Based on the cumulative experience of the past, the economic, professional and social climate of the present, with its increasing involvement of the patient/payer/consumer in decisions, and the enhanced inter-organizational coordination emerging from technologies of computers and communication science, the goal of creating comprehensive integrated systems as conceived in the 1950s and 60s may finally be achieved in the 1990s, but in a different form from that envisioned earlier. By judicious exploitation of computer and communication capabilities and the massive knowledge bases evolving from research, the way is eased for patient-centered integration and coordination of services without demanding integration in the sense of ownership or formal control of all the providers within a central organization.