Survey report; health needs of the 21st century

Int Health Dev. 1989 Summer;1(2):12-5.


PIP: Sustainability of development assistance programs depends greatly on the perceptions of priorities by recipient countries. A written survey was sent by the Catholic University of America's Institute for International Health and Development to 66 ministers of health in low-income and middle-income countries to assess their views of priority problems in health sector development. Response rate was 33%, coming from countries with highly diverse gross national products (GNPs), growth rates, mortality rates and life expectancies. Nevertheless, there was widespread agreement about priorities: 1) meeting costs of health care; 2) improving health care management and administration; and 3) extending communicable disease control. Communicable disease control and child health programs were more important to low-income countries than to middle-income countries. Costs, management and administration and the control of noncommunicable diseases were predicted to increase in importance. In demographics, urbanization, overall population growth and shift of workers from agriculture to industry and services were seen as the major problems of the past, and urbanization and the aging of populations accompanied by increasing life expectancies the major challenges of the future. Highest predicted training needs were for system managers and paramedical personnel. Government budgets, user fees and donor agencies were seen as the most important sources of past funding, with social security systems and fee-based payments increasing in importance in the future. The role of donor agencies would increase as would the need for more responsiveness. Future uncertainties include national economic growth, environmental problems, issues in ethics and changes in disease and technology.

MeSH terms

  • Age Factors*
  • Communicable Disease Control*
  • Delivery of Health Care
  • Demography
  • Economics
  • Ethics*
  • Financial Management*
  • Financing, Government*
  • Financing, Organized*
  • Geography
  • Health
  • Health Planning*
  • Health Services
  • Health Services Administration*
  • Health Workforce*
  • International Cooperation*
  • Organization and Administration
  • Population
  • Population Characteristics
  • Population Dynamics
  • Population Growth*
  • Research*
  • Social Planning
  • Technology*
  • Urban Population
  • Urbanization*