home page | Catalogue table of contents |
| How to order | WHO sales agents | Contact information |
Coordinated Health and Human Resources Development
Report of a WHO Study Group
Technical Report Series, No. 801
1990, 53 pages [Ar, E, F, S]
ISBN 92 4 120801 5
Sw.fr. 8.-/US $7.20; in developing countries: Sw.fr. 5.60
Order no. 1100801
Explores the theory and practice of coordinated health and human resources development as a concept that can help guard against the production of inappropriate categories or numbers of health personnel. Addressed to health policy-makers, educators, administrators, and planners, the report concentrates on what can be done to make education and training programmes more directly responsive to priority needs in the health services. The importance of coordination in the planning and management of the health workforce is also considered.
The most extensive section reviews findings from twenty-five case studies reported from seventeen countries. Each study provides a brief overview of the country concerned and the mechanisms affecting personnel planning, production, management and distribution, followed by examples of how the mechanisms have worked in practice. Mechanisms described include shifts in authority from the national to the provincial levels, changes in medical and nursing curricula, the use of national workshops and continuing education courses, and the development of model pilot projects.
An analysis of these case studies allows the identification of twelve major problem areas that have made it especially difficult to align education and training policies with the needs of the health services. The report concludes with a series of recommendations to WHO and to countries on the further promotion of coordinated health and human resources development.
The Crisis of Public Health: Reflections for the Debate
PAHO Scientific Publication, No. 540
1992, vi + 246 pages [E, S from PAHO]
ISBN 92 75 11540 0
Sw.fr. 56.-; in developing countries: Sw.fr. 39.20
Order no. 1610540
A wide-ranging analysis of what can be done, in the region of the Americas, to restructure health care within the context of a far-reaching economic crisis, deteriorating quality of services, glaring inefficiencies in health care, and growing inequalities. The book is the outgrowth of a PAHO project aimed at stimulating a fundamental rethinking of both the theory and practice of public health, particularly in view of a situation where most societies have proved unable to promote and protect the health of their populations, and where the majority of Latin American populations continue to experience excessive mortality rates in all age groups for most categories of public health problems, including many that are, in theory, easily preventable.
The book has three parts. Contributions in the first part trace the evolution of concern about the crisis and of PAHO's commitment to stimulate a rethinking of the theory and practice of public health aimed at a revitalization and reorientation of services, research, and teaching. The second part consists of eleven invited papers from leading experts, who present their views of the current crisis, consider its roots, and explore a wide range of remedial actions that might be taken in response to the deteriorating health situation throughout the region. A central question explored is whether different and more complex public health theories and practices are needed to support the formulation of new guidelines or policy directives for public health. The final part summarizes the conclusions reached by a consultative group convened to consider the need for changes in the theory and practice of public health in the Americas.
Economic Change, Social Welfare and Health in Europe
edited by L.S. Levin, L. McMahon, and E. Ziglio
WHO Regional Publications, European Series, No. 54
1994, xii + 131 pages [E]
ISBN 92 890 1318 4
Sw.fr. 29.-/US $26.10; in developing countries: Sw.fr. 20.30
Order no. 1310054
A collection of seven papers presented during a symposium which explored the impact of economic changes in Europe on social welfare and health. Focused on the social determinants of health, papers draw on the findings of several recent studies to assess the specific consequences of poverty and unemployment. Ways that national policy-makers might respond to periods of rapid economic change are also considered.
Guidelines for the Development of Health Management Information Systems
R. van Konkelenberg and I. Ring
Nonserial publication of the WHO Regional Office for the Western Pacific
1993, ix + 127 pages [E]
ISBN 92 9061 1065
Sw.fr. 18.-/US $16.20; in developing countries: Sw.fr. 12.60
Order no. 1520002
Provides guidelines, based on practical experience in Western Pacific countries, for the development of information systems as an aid to the more effective management of health services. Emphasizing the complexities involved in efforts to improve the timeliness, quality, accessibility and use of health-related data, the book aims to help health authorities and senior managers think through all steps of the planning process before any decisions are made or resources committed.
The book has two parts. The first, concerned with the development of a major system for health information, takes readers step-by-step through the various activities needed for thorough planning. Readers receive advice on how to calculate costs, estimate staff needs, conduct a situation analysis, identify the types and forms of data needed by different users, conduct a situation analysis, finalize project plans, and understand which technical computing tasks will be required. The second part explains how a national system for health information can be coordinated with other, smaller information systems, such as those for hospitals, human resource management, specific diseases, epidemiological monitoring, and systems for collecting and storing data on individual patients.
Health Care for the Poor in Latin America and the Caribbean
PAHO Scientific Publication, No. 539
1992, v + 234 pages [E, S from PAHO]
ISBN 92 75 11539 7
Sw.fr. 56.-; in developing countries: Sw.fr. 39.20
Order no. 1610539
Reports the results of a comparative study of problems confronted by the health care systems in Latin America and the Caribbean, a region where an estimated 130 million of the poor currently have no access to health care. The study, which focuses on conditions during the 1980s, was designed to analyse the current and potential capacity of health systems to provide adequate health protection for the poor. Recommendations for the reform of health care are also presented.
The book has four main chapters. The first profiles the poor populations in this region with statistics indicating the magnitude and incidence of poverty, characteristics of the poor in urban and rural areas, and the extent of access to social services. Levels of health care and access to services are evaluated in the second chapter, which provides systematic information on all 20 Latin American countries and selected Caribbean countries. The third and most extensive chapter gives an in-depth analysis of health care provided by the public, private, and social insurance sectors in five representative countries: Costa Rica, the Dominican Republic, Mexico, Peru, and Uruguay. The final chapter summarizes findings from the case studies and explores the possibility of replicating successful programmes elsewhere.
Health Conditions in the Caribbean
PAHO Scientific Publication, No. 561
1997, xiv + 326 pages [E]
ISBN 92 75 11561 3
Sw.fr. 62.-/US $55.80; in developing countries: Sw.fr. 43.40
Order no. 1610561
A comprehensive overview of health conditions, and the factors that shape them, in English-speaking countries of the Caribbean. Authored by experts with first-hand knowledge of these countries, the volume aims to identify common health problems, trace their causes, assess trends over time, and thus help define areas for priority action. Throughout, particular attention is given to shared problems and opportunities for collaborative action to solve them, particularly in view of this region's long history of collective action.
The book contains fifteen chapters presented in two parts. The seven chapters in part one explore the social, economic, and political factors that have shaped health conditions in the Caribbean and help explain recent trends. Problems identified include geographical isolation, severe financial constraints, shortages of equipment and essential drugs, deteriorating health facilities, inadequacies in planning and management, and weak communications systems. Chapters in part one also consider what is being done to improve conditions through the use of health legislation, research from within the region, health promotion, and programmes focused on women's health.
Chapters in part two describe regional and national developments in eight specific areas of health. Five of these correspond to priorities identified by the Caribbean Cooperation in Health initiative: maternal and child health, food and nutrition, control of noncommunicable diseases and injuries, AIDS prevention and control, and environmental protection, including the response to natural and man-made disasters. Other chapters discuss problems linked to the growing population of the elderly, describe the most important mental disorders and the services available for coping with them, and present the results of oral health surveys conducted in the region.
Health for All Targets: The Health Policy for Europe
Click here to fiew these targets online
European Health for All Series, No. 4
1993, xi + 228 pages [E, F, G, R]
ISBN 92 890 1311 7
Sw.fr. 36.-/US $32.40; in developing countries: Sw.fr. 25.20
Order no. 1360004
The updated edition of a unique statement of health priorities as formulated and agreed upon by national experts and ministers in virtually all the countries of Europe. The product of an unusual collaboration among nations with widely divergent political and economic systems, the book sets out 38 precise targets identified as essential to the European-wide improvement of health. These new and revised targets reflect changes that have taken place since 1984, and are based on a more up-to-date understanding of the problems involved in target setting and achievement. Throughout the book, health targets reflect the central agreement that inequity in health can and must be reduced, and that people must be given the social and economic opportunities to develop and maintain their health.
The 38 targets are presented in five main chapters. The first covers the improvements in health that need to be achieved by the year 2000. Other chapters address the health work needed to attain healthier lifestyles, and consider the contribution that environment makes to health. Targets in the remaining chapters cover the provision of appropriate health services and the infrastructure needed for sustained political, managerial, and financial support for health strategies set out in the previous chapters. Each target is presented together with the problems that need to be addressed and the suggested means of solving these problems.
"... should be mandatory reading..."
Journal of the Institute of Health Education
"... an intriguing book ... gives an
enlightening glimpse of the work of WHO and its ambitious `Health for all' project ...
worth a place in any health-based library..."
Journal of District Nursing
Health System Decentralization
Concepts, Issues and Country Experience
edited by A. Mills, J.P. Vaughan, D.L. Smith and I.
1990, 151 pages [E, F, S]
ISBN 92 4 156137 8
Sw.fr. 26.-/US $23.40; in developing countries: Sw.fr. 18.20
Order no. 1150340
Evaluates the extent to which decentralization can serve as a policy instrument for the improvement of a nation's health system. Addressed to policy-makers and administrators, the book combines a literature review with an analysis of country experiences to define what decentralization actually means when applied to the organization and management of health services. While noting the many theoretical benefits of a decentralized health system, the book concentrates on the gap between the intentions and the reality, stressing facts and arguments that show why decentralization is never easily implemented and rarely brings immediate gains. Problems identified include the resistance of civil servants to a change in the power structure, the difficulty of persuading staff and their families to accept peripheral posts, and the risk that greater local authority will mean greater opportunity for patronage and corruption. Throughout, emphasis is placed on the need to accept the fact that reform requires a long-term commitment.
The main part of the book consists of case studies of decentralization as experienced in Botswana, Chile, Mexico, the Netherlands, New Zealand, Papua New Guinea, Senegal, Spain, Sri Lanka and Yugoslavia. Apart from illustrating the different legal and administrative mechanisms that support decentralization, these studies also provide a rich inventory of the many practical and human factors that ultimately determine the success of reforms. The book concludes with an analysis of lessons learned from these experiences. Policies for raising revenue and controlling expenditure are identified as the most sensitive issues, followed by a number of practical problems with personnel.
Improving the Performance of Health Centres in District Health Systems
Report of a WHO Study Group
Technical Report Series, No. 869
1997, vi + 64 pages [E, F*, S*]
ISBN 92 4 120869 4
Sw.fr. 14.-/US $12.60; in developing countries: Sw.fr. 9.80
Order no. 1100869
Explores ways to improve the performance of health centres as a key component of efforts to strengthen district health systems based on primary health care and thus meet local needs for preventive as well as curative services. The role of health centres in overall strategies for health development is emphasized. Noting that health centres continue to perform poorly in most parts of the world, the report makes a special effort to identify factors responsible for the discrepancy between the great potential of health centres and the reality of their performance. Throughout the report, experiences from around the world are used to illustrate both the challenges faced and innovative ways of meeting them.
The report has two parts. The first considers the role and functions of health centres and looks at the factors that influence their effectiveness. Issues discussed include political and legal frameworks, policies for management, the provision and training of staff, factors influencing the range and quality of services, and mechanisms for financing these services. Problems identified range from inadequate financial and logistic support, to the provision of services that are either of poor quality or inappropriate to local needs, from the paucity of data for planning and management, to poor and irregular salaries that undermine the commitment of staff.
Against this background, the second section considers the radical changes needed to convert health centres from providing largely curative services to offering a comprehensive and dynamic primary health care programme. Four lines of activity are identified: defining the health centre's catchment area and developing a community profile, adopting a systematic approach to planning and implementation, generating the information needed to support health centre operations, and defining an active research and development agenda. The report then explains how each of these objectives can be achieved using a range of practical tools for generating information and using this information to improve planning, management, and services. The report concludes with an annex indicating the range of competencies and skills needed by staff in a properly functioning health centre.
Information Support for New Public Health Action at District Level
Report of a WHO Expert Committee
WHO Technical Report Series, No. 845
1994, iv + 31 pages [E, F, R, S]
ISBN 92 4 120845 7
Sw.fr. 8.-/US $7.20; in developing countries: Sw.fr. 5.60
Order no. 1100845
Considers the new information needs created by the growing trend to decentralize health care and give greater responsibility to health districts serving local populations. Noting that district health staff and management teams often lack essential demographic and epidemiological data, the report aims to identify the types of information that would provide the greatest support to the processes of planning, priority setting, resource allocation, and evaluation. An effort is also made to determine how this information can be gathered, processed, analysed, and put to good use, particularly in situations where public expectations for health care are rising as resources diminish. Throughout the report, emphasis is placed on new public health priorities that call for improved monitoring of equity in health status, quality of health care, and coverage and efficiency of district health services.
Main sections in the report describe weaknesses in currently available information, explain why locally-relevant data are so scarce, and outline general categories of information needed at district level. Other sections describe the range of methods that can be used to collect and process information, and offer advice on the analysis, presentation and reporting of health information.
Integration of Health Care Delivery
Report of a WHO Study Group
Technical Report Series, No. 861
1996, v + 68 pages [E, F, S*]
ISBN 92 4 120861 9
Sw.fr. 14.-/US $12.60; in developing countries: Sw.fr. 9.80
Order no. 1100861
Elaborates strategies and a detailed plan of action for achieving the integrated delivery of health services, using the district health system as a model. The development of an integrated health system is put forward as a means of achieving greater access to care, increased participation, more equity, and enhanced effectiveness, particularly in situations where a critical shortage of resources forces planners to look for new, cost-effective solutions. Throughout the report, experiences from a range of countries are used to illustrate the obstacles to change as well as specific approaches that have the greatest chance of success.
The report has six sections. The first, which establishes a framework for analysis, includes a tabular comparison of the advantages and disadvantages of vertical programmes and integrated health care services, and gives several examples of how integration actually works in practice. Additional background information is presented in the second section, which identifies the trends and factors that have encouraged efforts to integrate health services, particularly at the district level. Section three presents lessons about the effectiveness of different approaches.
The most extensive section uses a systems approach to develop a new model of the district health system, focused on managed, comprehensive, and integrated primary health care, and including the complete integration of the hospital and its services. Having established a model, the report then considers the obstacles to change, the likely causes of failure, and the ways that these causes can be rationally addressed. The report concludes with a detailed, ten-step plan of action. Country experiences with integrated health systems are reported in an annex.
Strengthening Health Management in Districts and Provinces
Handbook for Facilitators
A. Cassels and K. Janovsky
1995, vi + 74 pages [E, F, S]
ISBN 92 4 154483 X
Sw.fr. 20.-/US $18.00; in developing countries: Sw.fr. 14.-
Order no. 1150428
Provides the practical tools, advice, and encouragement needed to help district and provincial health management teams tackle - and overcome - problems encountered in their daily work. Addressed to facilitators, the book concentrates on the use of three carefully planned and timed workshops as a framework for identifying and analysing problems, developing practical solutions, and preparing and subsequently revising plans of action in the light of experience gained. The tools and techniques used at the workshops were developed and refined during two years of testing in the field. Based as it is on practical experience, the manual is also able to provide its readers with encouragement, showing how district managers in a diversity of settings have set about solving key problems of programme implementation - whether concerning the maintenance of vehicles or the supply of essential drugs.
The manual has three parts. The first, which provides an overview of the learning process detailed in the rest of the book, uses a question-and-answer format to address a wide range of questions the reader may have concerning why the process is needed and what it can achieve. The second part sets out operational guidelines for planning, facilitation and support. The third part, which constitutes the core of the manual, provides a detailed day-to-day guide to the scheduling of three separate workshops, the topics to be covered in each daily session, and the methods most likely to facilitate group participation and problem-based learning. The practical value of this material is greatly enhanced through the inclusion of a full set of model handouts to be used, after adaptation to the local situation, by participants.
"... one of the most practical and
`user-friendly' handbooks on the market for health managers and facilitators in developing
Health Policy and Planning
Towards a Healthy District
Organizing and Managing District Health Systems Based on Primary Health Care
1991, v + 105 pages [C, E, F, S]
ISBN 92 4 154412 0
Sw.fr. 19.-/US $17.10; in developing countries: Sw.fr. 13.30
Order no. 1150353
A practical, step-by-step guide to the ways in which better planning and management can be used to improve the services of district health systems. Firmly rooted in practical experience, the book adopts a problem-oriented approach, stressing plans and actions that respond to everyday problems and fall within the reach of the district health team. The objective is to help managers and other personnel in developing countries anticipate problems, avoid common errors, make wise choices, and keep ambitions in line with the realities of needs and resources.
The most extensive chapters concentrate on action. Details range from a list of factors to be considered when siting and designing the health centre to a series of sample treatment protocols and model job descriptions. Readers are reminded that the "supermarket" approach is a good model for organizing services, that training of traditional birth attendants in hospitals tends to institutionalize them and shift the responsibility for remuneration to the ministry of health, and that improvements in the status and financial rewards of staff may be needed to sustain motivation.
The remaining chapters cover monitoring and control, including the use of tracer diseases and sentinel sites, and offer tips and advice for evaluating interventions and for making the most out of lessons learned from experience. A tabular presentation of 46 standards for evaluating the district health system concludes the book.
"...the practical approach and extensive
examples in this text should prove genuinely useful..."
"... an excellent manual ... very down to earth,
concrete and practical..."
WHO in Europe: Meeting the Challenges
WHO Regional Publications, European Series, No. 57
1995, 17 pages [E, F, R*]
ISBN 92 890 1321 2
Sw.fr. 12.-/US $10.80; in developing countries: Sw.fr. 8.40
Order no. 1310057
A report on the activities of the WHO Regional Office for Europe, giving particular attention to health needs in the countries of central and eastern Europe and the newly independent states (NIS) of the former USSR. Activities are assessed according to progress in reaching 38 precise health targets agreed upon by all governments of Europe. The report also shows why this European-wide health policy remains a highly effective tool for meeting the goal of equity in health, for emphasizing the importance of disease prevention and health promotion, and for offering a comprehensive approach to the determinants of health, including lifestyles and the environment.
Activities reported include an attack on outbreaks of communicable diseases in the newly independent states, humanitarian assistance to the war-torn countries of the former Yugoslavia, health care reform in Kyrgyzstan, and a European-wide survey of the effects of environmental conditions on health. Other general areas of activity described focus on strengthening the roles of nurses and pharmacists, reducing the use of drugs, including alcohol and tobacco, and developing a network of health promoting schools. The report also explains what the Regional Office is doing to improve the health of women and children, to strengthen nutrition training in central and east European countries, and to improve the quality of health care, particularly in view of the serious deterioration in health services in the eastern part of Europe.