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The history and development of public health in low- and middle-income countries 

The history and development of public health in low- and middle-income countries
Chapter:
The history and development of public health in low- and middle-income countries
Author(s):

Than Sein

DOI:
10.1093/med/9780199218707.003.0003
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date: 16 January 2018

The socioeconomic health and other development status of the world have changed rapidly and radically in recent years. Spectacular scientific advancement has led humans into outer space and also to apply such advanced knowledge and skill to health sciences, with which millions of lives have been saved. Yet, the majority of people in over 150 countries around the world had a per-capita Gross National Income (GNI) of below US$10 725 in 2005, which are known generally, as the low- and middle-income (LMI) countries as classified by the World Bank (World Bank 2006a). People in many LMI countries live in poverty with inadequate healthcare and low health status. This chapter reviews the history and development of public health in LMI countries of which about one-third are classified as least-developed nations. It provides an insight that could contribute to the solution of present and future challenges and opportunities for health development which actually influence the health of the world. Learning from the experience of past developments in public health is an essential element in modern public health education. Some examples of public health development in LMI countries of Asia and the Pacific are highlighted.

The chapter firstly traces health systems development from the colonial period to the present century. It documents the post-independent efforts of LMI countries in their health development, within the context of socioeconomic and political development, including collaborative work at inter-country and international levels. In the next section, it briefly touches upon disease prevention and control, especially how LMI countries cope with the prevailing high morbidity and mortality conditions, and the major public health achievements and failures. The lessons in eradication and elimination efforts for preventing and controlling priority diseases provide a clear perception on the application of principles and practice of public health. It also highlights the links between the epidemiological, political, and financial aspects of disease control. The next section covers why and how there is a shift in the major causes of deaths and diseases in LMI countries with an increasing burden of chronic non-communicable diseases. This has led to adoption of measures and interventions beyond the usual health sector functions for reducing risks, such as legislative, environmental, and educative actions. These include the reduction of tobacco and alcohol use, avoiding unhealthy diets and promoting physical activity, or adopting multisectoral measures for road safety and injury prevention.

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