Health Cards (15)
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Another aspect of the CHC to consider:
As a clinician wanting to serve each individual in the most effective way,
some version of a CHC does have some attraction, I'd admit.
HOWEVER, I am also concerned about the effect such an enormous effort might
have on larger community health concerns. We do need to be very careful
not to encourage in the less-developed world the inordinate emphasis the US
places on individual responsibility for health. It is clear that many
health-related decisions are beyond individual control--but the CHC taken
to this proposed extreme does seem to shift the center of gravity back to
the individual.
Furthermore, the emphasis on illness episodes and prevention of specific
diseases in individuals seems unwarranted. Use TB as an example again--
although it is essential to effectively identify and treat existing TB
cases, we know for sure that crowded living conditions and lack of
rudimentary hygiene opportunities contribute enormously to the rise of TB.
. . we need to be addressing these larger problems with MUCH more money and
effort than we are (all over the world). Have you heard about "upstream
thinking"? Seems to me that grand CHCs are pretty far downstream; how
about working on more effective use of existing data?
Other thoughts?
Mary Kay Anderson
in East Tennessee USA
mailto:anderson@Access.ETSU-Tn.Edu
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