ita reproduced in Quaderni di Sanità Pubblica, Anno 16, aprile 1993, n°80

Explores the ways in which knowledge about the health impact of development policies can be systematically integrated into the process of policy-making, so that health objectives, along with macroeconomic objectives, are present at the outset of development planning. Noting that three decades of sustained development efforts have failed to improve the lives of the worlds disadvantaged groups, the book argues for a change of policy that puts health at the centre of economic choices and development decisions, with the health status of vulnerable groups regarded as a reliable indicator of socioeconomic progress. Details range from a discussion of lending schemes that can reduce dependence on welfare to a summary of measures that can mitigate the social costs of structural adjustment. Throughout, numerous case studies are used to illustrate the interactions between health status and economic development in a wide range of settings. The book has six main chapters. The first reviews global data from the 1980s that shed light on the determinants of vulnerability and point out weaknesses in past development strategies. Four interrelated determinants are identified: poor health status, lack of functional literacy, low income-earning capacity, and poor purchasing power. Readers are also reminded of the dangers of policies that confine the responsibility for public health to the health services, with the expectation that problems can be solved through expanded services and costly technologies. The second chapter discusses methodologies for identifying the most vulnerable groups and explains how, by focusing on the conditions of these groups, planners gain insight into the determinants of human development in a given society and the corrective strategies that are needed. Chapters three and four discuss the implications of functional literacy programmes on the management of socioeconomic development and evaluate various schemes for promoting productivity and economic enterprise in disadvantaged groups. The remaining chapters examine the larger issues involved when health is recognized as a condition of development, and consider how lending policies, at household, national and international levels, can be a powerful instrument for the simultaneous pursuit of both health and economic objectives.

eng fre.

ita.

WHODOC

WHO monograph

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