Problem-solving for better health.

The challenge of achieving health for all is enormous in the face of 500000 maternal deaths a year; the fact that 2.9 billion people lack clean water and sanitation; the AIDS epidemic and malaria prevalence; substance abuse; population aging; runaway urbanization; environmental degradation; and violent human conflicts. To develop new ways of thinking and approaches programs initiated by the Health Foundation of the Rogosin institute of New York entitled Problem-Solving for Better Health. The basic concept was that available limited resources (preventive therapeutic information talent and community) are seldom fully utilized rather than are often wasted. The program involves attendance of a workshop lasting 3-5 days by 60 health professionals. The problem-solving strategies are discussed in large groups with a handbook for supporting presentations. Community involvement and international collaboration are stressed and follow-up site visits take place after 6 months. The Health Foundations INFO-MED computer program and interactive information centers provide up-to-date information for professionals working on health problems. In China 54 professionals collaborated to solve health problems. In 1992 progress reports for 21 projects dealt with anxiety violent behavior attention-deficit disorders hyperlipidemia and wound healing. In Brazil 53 health professionals were enrolled in 1990 and prepared some 50 solutions to problems including patterns of violence among young males in Sao Paulo and nutritional deficiencies in slums. Six projects were implemented with 36 under development. In Ghana 65 professionals devised solutions to problems in 1991 12 projects are under way and 1 on hearing problems in school children is ready for national implementation. In the US a team from the University of Illinois Medical School launched a program in 1992 on geriatric pediatric and womens health issues. In Guyana 70 professionals participated in a workshop in 1992 to strengthen community-based programs. In Nigeria also in 1992 78 participants prepared protocols on family planning guinea-worm eradication and environmental health.