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This is an archived USAID document retained on this web site as a matter of public record.
Health, development and aid: changes and challanges
>> Foreign Aid in the National Interest >> Chapter 3 >> Health, development and aid Jump to Chapter 3 Sections:
>> Health, development and aid >> Broad progress, startling changes, persistent quandaries >> Health indicators: advances and obstacles >> Health systems and services >> To review the bidding >> Implications of trends for future directions >> Implications for the philosophy and pursuit of "foreign assistance" >> Notes >> Background paper >> References
Diversity and decentralization
Developing countries are increasingly diverse, socially and economically. Poor people in these countries long the targets of foreign assistance are no longer just illiterate subsistence farmers with large families, living far removed from markets in overwhelmingly agrarian economies. They are urban and rural, single and married, young and (increasingly) old, literate and illiterate, employed and unemployed, skilled, unskilled, and even professional, and from families both large and small. They live in economies that mix agriculture, basic manufacturing, and services, that receive varying amounts of foreign investment, and that have different levels of private and public ownership of means of production.
Yet within and across many developing countries, poor people still have one thing in common: they continue to suffer disproportionately from infectious diseases of global concern, including HIV/AIDS, tuberculosis, malaria, sexually transmitted diseases, and infant diarrhea. But growing numbers of poor people are also dying from diseases and conditions more common in industrial countries. These include hypertension, stroke, coronary disease, and diabetes, which can be managed through preventive care delivered at the primary level. Although these chronic diseases are of public concern, they have not been the focus of foreign assistance programs for health.
New, more flexible approaches are needed in international health care.International institutions increasingly speak of global health, yet most health services-public and private-are provided locally. The number of democratic countries is growing, and within them nonprofit organizations, consumer interest groups, and private providers are emerging and bringing health care closer to patients. Decentralization requires better standards and quality control for both public and private health services.
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Last Updated on: October 07, 2009 |
