A gold key to initiate a new situation in family planning work]

Because of the popularization of a responsible agricultural production system, the livilihood of peasants has been improving greatly, while the demands and needs of the general public are also increasing at the same time. Still under the influence of the traditional belief of carrying on one's family line and emphasis on having male children, married people prefer to have more childre, and the birth rate is now rising again. In order to solve this new problem, we need to teach the peasants national policies on population, land utilization, and food supply. In order to initiate a new situation in family planning work, we need to control this "gold key" of ideological education and propaganda. The emphasis should be placed on ideological education for cadres at all levels as well as the general public in order that they may understand the Party's strategy. Education on the national strategy should be combined with material interests of the peasants, and reward and punishment in production should also be linked up with that of family planning. Social measures are needed to reduce economic burdens of the peasants, offer better treatment for single-child households, and provide adequate care for old and retired people. Family planning projects should be consolidated and improved. Scientific management, facilities and techniques for birth control, compensation for working personnel in family planning, and other practical problems deserve immediate attention and solution.     

The meaning of patient satisfaction with prepaid primary health care in Israel

This paper reports the development of a self-administered Hebrew-language questionnaire for assessing patient satisfaction with primary care in Israel. Four scale measures of patient satisfaction were empirically constructed. These scales pertained to doctor conduct, doctor-patient communication, teamwork, and ease of access. In addition, a single direct question was used to measure overall satisfaction with the care. Ratings of all aspects of care were negatively skewed, with doctor-conduct and doctor-patient communication usually being the most satisfactory aspects and access the least satisfactory. It was shown that different practices, or the same practice at different points in time, can easily and meaningfully be compared, using mean satisfaction scores, measures of standard deviation, or percentages in each practice with ratings above (or below) the overall mean of all practices. The use of specific measures of patient satisfaction for comparison and intervention is discussed.     

Maternal care receptivity--an innovative approach for the evaluation of MCH services

Despite rapid expansion in the maternal and child health and family planning services, there have been few attempts made to study the extent of utilisation of these services and their impact. The present study reports a simple method evolved in the quantification of utilisation of maternal care services (called maternal care receptivity - MCR), the relationship of factors such as age, parity, caste of the women and the distance of the health centre on the MCR and the impact of MCR on perinatal and neonatal mortalities. An inverse relationship was observed between MCR and perinatal and neonatal mortality rates and the two rates were three times less among babies born to mothers with high MCR scores compared to those with poor MCR scores.     

The utilization of prevailing evaluation policy in the selection of performance measures

This study considers the problem of inferring a functional evaluation criterion from existing performance measure policies. The objective is to develop a rational basis by which to adaptively evaluate a current best set of performance measures from alternative sets. The analysis is based on a matrix approach for relating system characteristics to performance measures across a set of activities. A procedure for ranking measure combinations which are candidate implementation alternatives is devised using this matrix representation and cost information. An example illustrating the procedure is presented.     

Medical care, living conditions, and children's well-being

We examine the effect of medical care and living conditions on children's physical and psychological well-being. We develop a causal model in which living conditions (including the socioeconomic status of the family and the social-psychological aspects of family functioning) may affect well-being both directly, and indirectly through medical care. We find that families in the higher social classes and families that function well tend to go to large prepaid groups where they receive good medical care. High quality technical care of illness, in turn, improves physical health. The quality of psychotherapeutic care, on the other hand, has no effect on psychological well-being. For this aspect of health, the effect of living conditions is largely direct, rather than indirect by way of medical care. Families characterized by high levels of functioning have children who are psychologically healthy. In addition, physical health affects psychological well-being, but not vice versa.     

Explanation and social policy: 'the' problem of social inequalities in health

Inequalities in rates of sickness and mortality between social groups has long been a matter of concern and of inquiry in Britain. Disciplinary differentiation has resulted in the problem now being treated within what have become three distinct intellectual traditions. These are social administration, epidemiology, and sociology, and the accounts they provide differ significantly from each other. This is partly because 'the' problem is somewhat differently defined in each; and partly because of their different orientations to theory and to practical amelioration. This article explores the strengths and weaknesses of each approach, and raises the possibility of a more adequate explanation than any one discipline provides. The implications for study of social administration are considered.