6. Operational planning and management of health, 

 nutrition, and family planning programs 



7. Policy planning and basic data systems 



Given the nature of the needs in the fields of 

 health, nutrition, and population, the initiatives 

 recommended are somewhat more concerned with "soft 

 technology" (methods of management, organization, 

 education, information, research, and evaluation) than 

 with equipment. foe suggest the need to develop new 

 technologies, but, in general, we are more concerned 

 with adapting and transferring existing technologies. 



Several general needs run throughout the topical 

 discussions in this chapter. For example, an almost 

 universal need exists for more adequately trained 

 personnel at all levels of developing country health, 

 nutrition, and population programs. While training in 

 the United states in certain specialized research and 

 service-related fields is important, much of this 

 training is too theoretical and parochial for the needs 

 of developing countries. Such training contributes to 

 the out-migration of skilled manpower from developing 

 countries, particularly of physicians and nurses, 

 thereby aggravating rather than reducing needs for 

 skilled personnel. 



The predominant need is to strengthen in-country 

 training at all levels. Such training will tend to 

 strengthen weak infrastructures in health- related 

 sectors and permit more practical training programs 

 that emphasize field apprenticeship in rural and urban 

 low- income areas. 



There is growing realization of the need to 

 redefine the appropriate functions of the entire health 

 care team, transferring many curative and most 

 preventive functions from the doctor to other trained 

 personnel, local practitioners, and village health 

 workers. Training must be developed to meet the newly 

 defined job descriptions in the latter two categories 

 because not enough trained, modern health workers are 

 available to provide universal access to health and 

 family planning services. This problem is intensified 

 by the tendency of the more highly trained personnel to 

 reside in cities. 



Finally, although this chapter does not focus on 

 possible future health problems, one, occupational 

 health and safety, requires mention. Industrialization 

 and the use of new technologies can create a number of 

 health hazards. Much can be learned from the U.S. 

 experience in protecting workers and their families 

 from physical dangers, toxic substances, and mental and 

 psychological stress, without seriously inhibiting the 

 contributions of industry and technology to 

 development. U.S. government, labor, management, and 



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