Disease control and medical prevention
For a very simple reason: because the passive detection of patients and people at health risk improves when the rate of use of health services increases: the number of candidates increases with the number of patients. Here is the mathematical proof, with the analysis of the malaria control program in Mali and a simulation with African data.
Unger JP, d'Alessandro U, De Paepe P, & Green A. Can malaria be controlled where basic health services are not used? Tropical Med Int Health. 2006; 11,3: 314-322.
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-3156.2006.01576.x
Van Dormael M., Unger J.-P., De Paepe P. e-Letter. Health services are badly needed to control malaria (and other diseases). British Medical Journal25 May 2004;
http://bmj.bmjjournals.com/cgi/eletters/328/7448/1129#60538.
Epidemiological control programs are likely to damage the clinical practice of medicine. Here are some principles designed to prevent this from happening.
Unger J.-P., De Paepe P., Green A. A code of best practice for disease control programmes to avoid damaging health care services in developing countries Int J Health Planning and Management 2003; 18: S27-S39.
https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.723
But on the other hand, these programs can also improve the quality of care and the clinical practice of medicine. Here's how the choices that govern the management of disease control programs make them better or worse.
Unger J.-P. Can intensive campaigns dynamize front line health services ? The Evaluation of a Vaccination Campaign in Thiès Medical District, Senegal. Soc Sci Med 1991; 32(3): 249-259. Notice that this article also shows the importance of preventive medicine in public health
https://www.sciencedirect.com/science/article/abs/pii/027795369190101H
The international health policy allocates the disease control programs to public services and clinical medicine to the private sector. The lack of their integration explains the international policy failure. Theoretically, clinical care and public health interventions could have been integrated in private health services – and there were attempts to privatize disease control programs. But the following publications explain why the private sector with a commercial mission is not interested in handling these programs.
Unger JP, De Paepe P, Ghilbert P, Zocchi W, Van Dessel P, Qadeer I, et al. Privatization (PPM-DOTS) strategy for tuberculosis control: how evidence-based is it? In: Unger JP, De Paepe P, Sen K, Soors W, editors. International health and aid policies; the need for alternatives. Cambridge: Cambridge University Press, 2010:57-66.
De Paepe P., Devadasan N., Soors W., Unger J.-P. e-Letter. Public-private partnership for tuberculosis? British Medical Journal 24 Feb 2006
http://bmj.com/cgi/eletters/bmj.38738.473252.7Cv2#128759.
Ghilbert P., De Paepe P., Unger J.-P. e-Letter. Tuberculosis and the private sector: another wishful thinking?British Medical JournalOct 2003;
(http://bmj.bmjjournals.com/cgi/eletters/327/7419/823#38508).
To guide the public health and community medicine practice of clinicians in Africa, practitioners can use semi-quantitative estimates of local epidemiology. Here's how
Unger JP & Dujardin B. Epidemiology's contribution to health service management and planning in developing countries. Bulletin of WHO. 1992; 70,4:487-497
How important is it to protect workers from Covid-19? A comparative analysis
Unger J-P. Comparison of COVID-19 Health Risks With Other Viral Occupational Hazards. International Journal of Health Services. 2021;51(1):37-49. doi:10.1177/0020731420946590
https://journals.sagepub.com/doi/full/10.1177/0020731420946590#articleCitationDownloadContainer
Finally, here is a methodology for clinicians and public health doctors to design a disease control program on a defined territory, that is based on the epidemiological characteristics of the disease
Unger J.-P., Criel B., Mercenier P. The Vertical Approach - A methodology for the identification of priorities for action and research in disease control programmes. Studies in Health Service Organization and Policy 1998; 8: 17-43.
Copyright © All Rights Reserved