safe combinations of vaccines for administration in the 

 neonatal period (BCG, smallpox, etc.) 



Education, training, and community information 

 relevant to primary care are needed for individuals and 

 their families, health practitioners, and local 

 midwives, community health workers, family planning 

 f ieldworkers, nurses, doctors, etc. For example, 

 existing medically sound techniques, such as warming 

 the baby after delivery by placing it close to the 

 mother and putting warm blankets over both, could be 

 reinforced in the practice of local midwives, while new 

 techniques, such as measures to stop postpartum 

 hemorrhage, could be introduced through training. As 

 another example, physicians need to be taught how to 

 function in the absence of a fully equipped hospital as 

 well as within one. 



6. Operational Planning and Management of Health, 

 Nutrition, and Family Planning Programs 



A delivery system designed to improve the coverage 

 of health, nutrition, and family planning services 

 inevitably entails large-scale and unique problems of 

 management and coordination at all levels. Three 

 important needs are: (1) large numbers of 

 appropriately trained managers; (2) adequately 

 functioning support services; and (3) effective 

 supervision, communication, and feedback. 



Health professionals are usually not oriented 

 toward community efforts or trained in the social 

 sciences or management techniques, while general 

 administrators usually lack medical knowledge and are 

 accorded low status in the health sector. Yet, as the 

 importance of decentralization and the provision of a 

 wider range of integrated services becomes accepted, 

 the need for professionals with a proper balance of 

 technical and managerial knowledge and skills expands, 

 while hospital adminstration is a recognized 

 discipline, the management of primary care is not, and 

 the latter has unique features that require innovative 

 training programs. 



Basic health, nutrition, and family planning 

 services also require adequate support systems which 

 typically do not receive enough attention relative to 

 personnel development and training. Personnel 

 effectiveness is frequently hampered by the inadequate 

 and unreliable delivery of medicines and supplies, 

 equipment ill suited to local conditions and not 

 properly maintained, and inadequate transportation and 

 communication facilities. 



Finally, the collection of operational information 

 for routine administrative reports consumes 



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