Planificación nacional y establecimiento de normas de higiene maternoinfantil en América Latina : Intergracion de las actividades de higiene y atención médica a un nivel funcional / National planing and the construction of maternal and child hygiene norms in Latin America

The magnitude and extent of the health problems of mothers and children in Latin America far exceed the resources available to meet them, and from all present indications, the numbers of medical and paramedical personnel will remain inadequate for many years to come. It is therefore important to have norms of service - at the national, regional, and local levels - which will assure the greatest returns for the specific efforts rendered. One of the obstacles to achievement of this objective is the fact that norms of maternal and child hygiene have not been based upon realistic planning techniques nor integrated functionally into a system of comprehensive health care. They have repeated a standardized pattern of service organization and content which derives historically from the urban areas of industrialized countries rather than adapting themselves to local needs, cultural conditions, and the personnel resources and facilities of a comprehensive system of health care. The actions of maternal and child hygiene can be grouped into those which screen for early unrecognized disease, or provide anticipatory guidance and parental education, and those which deliver a dietary supplementation or immunization. All of these actions can be viewed as component parts of programs to prevent or combat the effects of a specific disease. In the context of health planning, manternal and child hygiene can be

Tratamiento de la deshidratación diarreica mediante el suministro de líquidos por vía endovenosa, con especial referencia a la situación en la América Latina / Intravenous fluid therapy of diarreheal dehidaration with special reference to Latin America

1) The choice of a solution for intravenous rehydration is in many clinics based on clinical estimates of the patient's osmotic disturbance and the severity of acidosis. Even when biochemical measurements are possible, however -and these correlate poorly with the clinical assumptions- the relevance of this knowledge to appropriate therapy is not known. Recommended solutions vary widely, from alkaline multielectrolyte mixtures with a concentration of 300 mOsm/L ("isotonic") or even higher to one-third or one-half isotonic solutions of sodium chloride. The simpler, less concentrated solutions are theoretically preferable in that they provide more "free water". They are being used with good results in both "hypertonic" and "hypotonic" dehydration by an increasing number of clinics

2) Since most children with diarrhea are malnourished and many have associated infections, several factors may contribute to therapeutic success or failure. If the relative contribution of each of these factors could be more precisely defined, beneficial changes in therapeutic emphasis might ensue. First, however, objective, individualized estimates of dehydration and malnutrition are needed. Dehydration should be measured in terms of weight lost or regained rather than by clinical appraisal. The estimate of malnutrition should if possible be based on comparison of the patient's weight with his own ...(AU)

Ideas para la formulación de un plan de control de las infecciones entéricas, incluyendo medidas de saneamiento ambiental, epidemiología, educación para la salud y de diagnóstico y tratamiento oportuno / Ideas for the formulation of a plan for the control of gastro-intestinal diseases, including environmental sanitation measures, epidemiology, health education, and early diagnosis and treatment

1=one. Measures of proven effectiveness exist which can reduce morbidity and mortality from diarrheal diseases, paraticularly as they affect young children. These measures are not as widely applied as they might be

2=two. Simple field epidemiologic methods of study can help give direction and emphasis to the control measures applied

3=three. In the application of control measures there is need to collect systematically informatin which will clarify the precise effect of the specific measures applied so that future program planning and execution can be undertaken in the most economical and effective manner possible

4=four. The central theme of planning and executing control efforts should be the principle that people can do for themselves if they only know what to do and if what to do is made possible(AU)

Planificación nacional y establecimiento de normas de higiene maternoinfantil en América Latina : Intergracion de las actividades de higiene y atención médica a un nivel funcional / National planing and the construction of maternal and child hygiene norms in Latin America

The magnitude and extent of the health problems of mothers and children in Latin America far exceed the resources available to meet them, and from all present indications, the numbers of medical and paramedical personnel will remain inadequate for many years to come. It is therefore important to have norms of service - at the national, regional, and local levels - which will assure the greatest returns for the specific efforts rendered. One of the obstacles to achievement of this objective is the fact that norms of maternal and child hygiene have not been based upon realistic planning techniques nor integrated functionally into a system of comprehensive health care. They have repeated a standardized pattern of service organization and content which derives historically from the urban areas of industrialized countries rather than adapting themselves to local needs, cultural conditions, and the personnel resources and facilities of a comprehensive system of health care. The actions of maternal and child hygiene can be grouped into those which screen for early unrecognized disease, or provide anticipatory guidance and parental education, and those which deliver a dietary supplementation or immunization. All of these actions can be viewed as component parts of programs to prevent or combat the effects of a specific disease. In the context of health planning, manternal and child hygiene can be

Tratamiento de la deshidratación diarreica mediante el suministro de líquidos por vía endovenosa, con especial referencia a la situación en la América Latina / Intravenous fluid therapy of diarreheal dehidaration with special reference to Latin America

1) The choice of a solution for intravenous rehydration is in many clinics based on clinical estimates of the patient's osmotic disturbance and the severity of acidosis. Even when biochemical measurements are possible, however -and these correlate poorly with the clinical assumptions- the relevance of this knowledge to appropriate therapy is not known. Recommended solutions vary widely, from alkaline multielectrolyte mixtures with a concentration of 300 mOsm/L ("isotonic") or even higher to one-third or one-half isotonic solutions of sodium chloride. The simpler, less concentrated solutions are theoretically preferable in that they provide more "free water". They are being used with good results in both "hypertonic" and "hypotonic" dehydration by an increasing number of clinics

2) Since most children with diarrhea are malnourished and many have associated infections, several factors may contribute to therapeutic success or failure. If the relative contribution of each of these factors could be more precisely defined, beneficial changes in therapeutic emphasis might ensue. First, however, objective, individualized estimates of dehydration and malnutrition are needed. Dehydration should be measured in terms of weight lost or regained rather than by clinical appraisal. The estimate of malnutrition should if possible be based on comparison of the patient's weight with his own ...(AU)

Ideas para la formulación de un plan de control de las infecciones entéricas, incluyendo medidas de saneamiento ambiental, epidemiología, educación para la salud y de diagnóstico y tratamiento oportuno / Ideas for the formulation of a plan for the control of gastro-intestinal diseases, including environmental sanitation measures, epidemiology, health education, and early diagnosis and treatment

1=one. Measures of proven effectiveness exist which can reduce morbidity and mortality from diarrheal diseases, paraticularly as they affect young children. These measures are not as widely applied as they might be

2=two. Simple field epidemiologic methods of study can help give direction and emphasis to the control measures applied

3=three. In the application of control measures there is need to collect systematically informatin which will clarify the precise effect of the specific measures applied so that future program planning and execution can be undertaken in the most economical and effective manner possible

Report of the Rapporteur of the Technical Discussions

4=four. The central theme of planning and executing control efforts should be the principle that people can do for themselves if they only know what to do and if what to do is made possible(AU)