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Integrated school health services. American Academy of Pediatrics Task Force on Integrated school Health Services.

When integrated school health services are implemented according to an assessment of community needs and resources, and with adequate attention to quality assurance and evaluation, they may be a way to expand access to health care services for underserved populations. They can also become a coordinated extension of an ongoing medical care home. This approach may be an effective vehicle for integrating psychosocial care and education with medical care. Pediatricians practicing in public and private sectors should become actively involved in any community effort to develop an integrated school health services initiative. The well-designed integrated health services program, when coupled with comprehensive school health education, could significantly advance the state of health of the nation's children, youth, and families.

Adolescent↗

Organizations and structures that facilitate community research.

The Southwest Oncology Group has become a model for other oncology organizations in the way it facilitates participation of community physicians and their cancer patients in clinical trials. The Southwest Oncology Group accomplishes this through its Community Clinical Oncology Program and Cooperative Group Outreach Program. The Community Clinical Oncology Program brings state-of-the-art cancer treatment, prevention, and control research to the community hospital setting, where most cancer patients receive treatment. The Cooperative Group Outreach Program broadens community participation in clinical trials beyond the extent achievable through Community Clinical Oncology Program. Together, these programs have succeeded in increasing community physician participation in clinical trials and have shown that community physicians are capable of submitting data comparable in quality to those obtained in the academic setting.

Cancer Care Facilities↗

[Generic drugs in developing countries].

Drugs are generally considered as consumer goods which serve to protect, maintain and restore health. In recent years, the proportion of national expenditure devoted to health has increased in all developing countries. The use of generic drugs can reduce health costs, if part of a national drug action plan, and their quality is confirmed (quality control, distribution system, correct utilization). Nevertheless, a large proportion of the population in developing countries has no access to these drugs. This situation requires establishing financing schemes for drug supplies, with community involvement and participation of the population. However, such schemes can result in limited access and inequity.

Africa South of the Sahara↗

The emergence of providers as health insurers.

The traditional delineations between providers of health care and insurers are becoming blurred. The author describes the trend toward creation of provider/insurers, the current miasma of regulatory and legislative activities surrounding the issue, and the market and operational forces also at play.

Attitude of Health Personnel↗

Engaging support.

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Community-Institutional Relations↗