The influence of child spacing on child survival

Summary This study evaluates the strength of the influence of spacing on child survival. Data related to a traditional culture (Punjab) in which almost all children are breast-fed up to the age of 17 months. An initial pregnancy history survey, subsequent four years updating through continuous monitoring of vital events and a second cross-sectional pregnancy history survey at the mid-point provided a file containing information on pregnancies and survival of children of 5,018 women. The analysis first looks at the correlation between the lengths of the preceding and subsequent intervals of index children, then examines whether this correlation was related to the repeated pattern of child death or survival. Next, the influence of the duration of the preceding interval on the survival of the index child in general and after accounting for the fate of the preceding child were considered. Then the influence of the length of the subsequent interval on the survival of the index child after conception and after the birth of the next child were studied. Lastly, regression analyses with preceding and subsequent intervals as independent variables and age-specific survival or death as the dependent variable were performed.     

Program analysis using the client oriented cost outcome system.

The client oriented cost outcome system has been under development in Pennsylvania community and hospital programs since 1972. The system builds upon the behavioral and decision data generated with or on behalf of consumers. Flexibility for local program system design is permitted if the procedures of consumer intake, review, and termination document each consumer's (a) problems, resources, and goals, (b) overall functioning level in their ordinary community, and (c) services intended and rendered as related to (a), above. While the system's primary application is in providing feedback for local program quality assurance and evaluation procedures, aggregation of data permits program planning and evaluation at county, state, and federal levels in terms of (a) client demographic or diagnostic characteristics, and (b) program service characteristics and objectives.     

Setting health priorities: a review of concepts and approaches

The setting of health priorities is primarily concerned with the equitable distribution of resources and is now more than ever an important part of strategic planning within the National Health Service (NHS). The basic information which can be used to assist in such decision-making and the process by which different agencies become involved are important aspects of priority-setting; this article is based on a major review of the research literature on these aspects and provides a discussion and an analysis of experience within health and other fields. From this material a number of possible approaches to priority-setting are identified and discussed. The article concludes that, before it can be decided how priorities should be set in the future, outstanding questions about how far rational approaches are feasible, about who is to be involved and what role they should play, and about how far such decisions are to be taken nationally or locally will need further consideration.     

Optimal Times to Contact Sample Households

Finding a suitable respondent at home is an essential and expensivecomponent of a household survey. This article reports on theresults of a study of the probabilities of finding someone aged14 or older at home and discusses the application of such datato survey design and budgeting.     

Evaluating a private foundation's health program

Public policy decisions in health are increasingly difficult and expensive. Although there will never be enough information available, private foundations can help to bridge the most important gaps in knowledge. Larger foundations may also wish to respond to those who doubt the value of foundation activities. This article reviews the experiences over the past eight years of The Robert Wood Johnson Foundation in employing evaluation and related social research procedures in the planning and implementation of a major philanthropic effort to improve the health and medical care of Americans. Discussed are the still evolving Foundation evaluation framework, the unanticipated problems in undertaking specific evaluations, and the substantive findings of some of the studies.     

Social forecasting: An integral part of corporate planning?

The increasing need for business to monitor the social dimensions of its environment and, hopefully make some forecasts of future trends has met with some constructive response from academics and consultants although not as yet on a very liberal scale. The published literature does not indicate to what extent companies in general attemp social forecasting and, where they do, the degree of integration which exists within their corporate planning systems. The authors, therefore, decided to survey a sample of British organizations to see if they could shed some light on these issues and thereby add some information to the excellent accounts of individual cases of social forecasting in, they suspect, the more advanced and atypical companies. The survey suggests a general picture of: awareness of the value of social forecasting; fairly widespread ignorance of the techniques which do exist, primitive though these may largely be; successful integration of social forecasting into the corporate planning systems of a substantial number of organizations but not in the majority.