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International Health at 50

International Health at 50 (continued)

Community–Based Research and Health Care

The Department’s approach to community-based public health centers on collaboration with local populations. Together, they first identify health problems and then test intervention strategies under realistic conditions. The goal is developing inexpensive, evidence-based health programs. This strategy began with Carl Taylor’s signature field study—the Narangwal Rural Health Research Project—which lasted from 1965 to 1974. The project demonstrated that community health workers (CHWs) could deliver quality health care. Among its seminal findings: CHWs can cheaply and effectively treat pneumonia cases by administering antibiotics themselves.

1978: Carl Taylor is the top consultant to WHO in drafting the historic Alma Alta Declaration, which advocates an integrated primary care approach to public health over the traditional disease-control model. Signed by representatives from 134 countries, the document states that primary care brings “health care as close as possible to where people live and work and constitutes the first elements of a continuing health care process.”

1980: To curb a childhood diarrhea epidemic that was killing infants at seven times the national average on the Fort Apache Indian Reservation in Arizona, Mathuram Santosham partners with tribal leadership to train parents in oral rehydration therapy (ORT). Further studies help make ORT the first-line therapy for diarrhea treatment.

2008: Abdullah Baqui and researchers in Bangladesh develop a package of maternal and newborn care services. Relying on local women to provide care, the initiative reduces neonatal mortality by 34 percent in 30 months. The research—recognized by The Lancet as a 2008 paper of the year—encourages WHO-UNICEF to recommend postnatal home visits to improve newborn survival.

2009: Prenatal and newborn care and maternal life skills delivered by lay health workers to American Indian teen mothers significantly improve infants’ social, behavioral and emotional development. The study, led by John Walkup and Allison Barlow, is recognized by the Journal of the American Academy of Child & Adolescent Psychiatry as a 2009 paper of the year.

“If you’re interested in disadvantaged or vulnerable populations, you need to get them engaged in ways that are meaningful. Community empowerment approaches have long been a part of our work.” —David Peters


  • Martin

    France 10/19/2011 04:18:03 PM

    It is surprising that the field of International Health makes virtually no mention of water, sanitation and hygiene. Is the ultimate message of IH simply that prevention is a waste of time and curative approaches are the only viable ones? I doubt that Carl Taylor would have endorsed that. In fact, the notion that "It's the people themselves who have to take ownership of their own health care" is probably very closely linked to the concept of "community led total sanitation". International Health needs to understand Environmental Health.

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Origins of International Health

Origins of International Health

He was there: Carl Taylor recalls the reasons behind the birth of what is now global health.

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