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UNITED STATES TECHNICAL ASSISTANCE TO NURSING
?44 lZ LATIN AMERICA
1942-1966
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R'idial Swwe9
UNITED STATES
TECHNICAL ASSISTANCE TO NURSING
Agency for International Development Washington, D. C.
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HISTORICAL SURVEY
OF
UNITED STATES TECHNICAL ASSISTANCE TO NURSING
PART III - LATIN AMERICA
1942-1966
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Introduction - - -
Resumes of Individual Country Programs -
Bolivia - -
Brazil - - -
British Guiana - - -
Chile -
Colombia -
Costa Rica .------
Dominican Republic -
Ecuador -
El Salvador - -
Guatemala
CONTENTS
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iv
1
15
27
30
45
65
75
84
98
114
Faiti
- Honduras
Mexico
Nicaragua
Panama
Paraguay
Peru
Surinam
Uruguay
Venezuela
129
138
147
161
173
187
203
215
217
228
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Over the past 23 years, the Agency for International Developnent
and its predecessor agencies have supported technical assistance to
develop and improve the nursing services to people in 48 countries.
The following report provides a factual record of these activities
and documents the status of nursing development in each country at
the time the AID program began, and at the end of 1965 or at the
time U. S. bilateral program was terminated. When available,
information about specific nursing programs of private foundations
and multilateral agencies has been included, since the progress
which is recorded is the result of the total output of technical
assistance combined with each country's own substantial development
efforts.
This report was prepared to provide an orderly historical
country-by-country record of USAID contributions to nursing
development and a review of some of the changes that have occurred.
It is also intended to serve as a basis for assessing past
achievements and for sound planning for effective assistance in
future nursing and health programs.
To prepare the sunmaries, all pertinent written material in the
Agency's files in Washington was reviewed, as well as various
official publications of AID, the World Health Organization, and
other Government and private agencies. Additional information was
obtained through conversations
with a number of technicians who participated in the country
programs. The task of tracing program development in each of the
countries was complicated by the lack of uniformity in the
reporting of AID health activities over the years. Since its
inception, the Agency has undergone several major reorganisations
and policy changes altering the nature of many of its assistance
programs. There are undoubtedly some omissions in the factual
record presented, but the data are as complete as is possible from
the material available. It has not been reviewed for accuracy or
completeness by officials of the countries assisted.
This document is intended for use by AID personnel and, on
request, by educational institutions and others with a particular
interest and need for this information. Because of the limitations
cited above, it is not available for general distribution.
For easier handling, the report has been produced in -four
parts:
part I - Africa
Part II Par East
Part III - Latin America
part IV - Near East South Asia.
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.ivennaAM RxsuNs
Fifteen (15) U.S. public health nurse advisors and one (1)
midwifery advisor worked in Bolivia for a total of 32 years between
1942 and 1963. With their Bolivian counterparts, many of whoe had
participant training to increase their public health nursing
skills, they established the first organized public health nursing
services in the country. A Ministry of Health Nursing Division had
its beginnings in the Public Health Servicio which developed a
network of local public health services. U.S. nurses organized and
supervised public health nursing services in health centers and
mobile clinics, taught nursing and midwifery auxiliaries in schools
which they helped establish and in on-the-job training programs,
and helped to integrate public health nursing in the general nurse
training schools. The seven (7) Bolivian nurses who bad participant
training grants re-. turned to their country to assist and later to
take full responsibility for the developing nursing services of
their country. when USAID assistance to nursing was terminated, the
public health nursing service was well established, a National
Nurses Association had been organized, the World Health
Organization (WHO) was assisting with basic nursing education and
the number of nurses had increased from I to 100,000 people to 16
per 100,000. However, the statues of nursing and its economic
rewards. had not improved sufficiently to prevent the emigration of
many of the most able Bolivian nurses.
BRAZIL
USAID nursing assistance to Brazil began in 1942, and was
terminated in 1963. During that time, USAID has provided 35 nurse
advisors for a total of 90 years of service, funds for building or
remodeling nursing schools and health centers, teachers' salaries,
teaching materials and textbook translations, and has shared in the
operating costs of new practical nurse schools and health centers.
USAID nurses have assisted in the organization and administration
of public health nursing services and in the up-grading of hospital
nursing care, nursing schools, and auxiliary training programs. A
post-graduate course in public health nursing was developed, and
in-service training programs were conducted for nurses and for both
hospital and
public health auxiliary workers. Nursing development in Brazil
has had substantial assistance from the Rockefeller and Kellogg
Foundations and the Pan American Health organization (PAHO) as well
as from the Agency for International Development. Through the
individual and combined efforts of all these agencies, Brazilian
nurses were assisted in their new roles as planners,
administrators, and teachers. The reorganized National Nurses
Association, conducted the first Survey of Brazil's Nursing Needs
and Resources. Although there are still vast areas of Brazil where
people have no nursing or health services, the pattern and the
leadership for further development exist. Many of the Brazilian
nurses who studied in the United States under USAID participant
training grants are among the corps of national nurses well
qualified to carry on the development of their country's nursing
services and to give leadership to nursing development in other
Latin American countries. Brazil's requests for assistance now. are
for specialized consultation in new programs and in the design and
conduct of operational research as a basis for health services and
manpower planning.
BRITISH GUIANA
One (1) USAID nursing advisor was requested and assigned to
British Guiana from 1962-1964 to assist in a Survey of Nursing
Services and Resources. Her recoeandation for continuing assistance
to the country to develop national nursing leadership was not
implemented by the Agency for International Development (AID).
The Pan American Health.Organization, the lockefeller and
Kellogg Foundations, and the Agency for International Development
have all assisted in this development. Specific AID input has
included 2 USAID nursing advisors who spent a total of 6 years
assisting with the development of public health nursing services in
Chile. Nursing services were organized in Servicio health centers,
same
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(Continued)
of which served as field training centers for Chilean nursing
students. A short auxiliary nurse training program was developed
and has been carried on by national nurses. Regional and short-term
consultants assisted with plans for nursing school construction and
with training courses and demonstration services to improve the
quality of hospital
-nursing care. Since 1943, a Nursing Division has been
established in the Ministry of Health in Chile, legislation has
been enacted to control nursing practice, and the Chilean Nurses
Association has gained membership in the International Council of
Nurses. Public health nursing services have been developed, and
Chilean nursing schools have increased in number and quality. A
serious problem has been that many of the beat Chilean nurses
tended to emigrate to other Latin American countries and the United
States because of the low salaries paid in their home country. An
effort has been made in recent years to correct this situation.
COLOMBIA
USAID participated in the development of nursing in Colombia
from 1943 to 1963. During that time, substantial assistance was
also given by the Pan American Health Organization (PAO), and the
Rockefeller and Kellogg Foundations. In that 20-year period, a
Division of Nursing was established in the Ministry of Health;
legislation was enacted to control nursing practice; public health
nursing services were developed; training was initiated or
up-graded in 6 nursing schools and 25 auxiliary training programs;
skilled nursing care and organization of nursing services were
demonstrated in selected hospitals; 3 graduate training programs
were developed; corps of senior Colombian nurses were better
prepared to teach, plan, and administer nursing services. Seven (7)
AID nurse advisors spent a total of 26 years in Colombia organizing
public health services and public health field experience for
nursing students; establishing 2 auxiliary nurse training programs;
organizing, teaching, and preparing teachers for the National
School of Nursing; conducting short training programs for
nurses
at all levels; and assisting in the improvement of hospital
nursing services. Through a contract with Catholic University, some
10 nurse specialists gave consultation to all 6 schools of nursing.
This contract was terminated after 2 years by mutual agreement
because it was "too little trying to do too much." The National
Nursing School building was constructed and equipped, training
hospital wards were remodeled, textbooks translated, and faculty
salaries paid until they could be taken over by the school. One (1)
AID nurse served as director of the school until her Colombian
counterpart had had participant training in the United States.
Other Colombian nurses had advanced training as AID participants.
The framework for a modern nursing service existed when the AID
nursing program was terminated, a few islands of excellence were
developing with assistance from other agencies, but there were only
1,100 nurses for 151 million people, many of whom have no nursing
care except that given by untrained auxiliaries.
COSTA RICA
Nursing is not new in Costa Rica--its National Nursing School
was established in 1917. Goals of the AID assistance program, like
those of the FAHO, have been to help the country increase both the
quantity and the quality of nursing care. Between 1944 and 1960,
eleven (11) AID nurse advisors worked in Costa Rica for a total of
16 man-years.. They organized and supervised the nursing services
in the country's first 10 Servicio Public Health Centers, and aided
in the establishment of a Department of Public Health Nursing in
the Ministry of Health. For a brief period, AID gave limited
financial and technical assistance to the nursing school, but the
long-term guidance needed for successful institutional development
has been given by PAHO and the University of Kansas. Costa Rican
nurses were given in-service and participant training in the
organization and improvement of hospital nursing services and in
surveying hospital needs and setting up demonstration programs.
Nineteen (19) nurses had AID participant training in public health
and hospital nursing services.
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DOMINICAN REPUBLIC
Two (2) AID nursing advisors were assigned to the Dominican
Republic from 1954-1957. Becamse the Public Health Servicio project
had been phased out some years before, these advisors were attached
to the Education Servicio. They assisted with plans to open a
National School of Nursing, arranged participant training for 2
national nurses, conducted in-service training programs for
graduate nurses, and planned and helped in the training of 52
auxiliary nurses. The record shows that there liere many
difficulties--lack of funds and facilities end unclear agreement
about AID, PAED, and host government commitments, and AID
assistance was terminated.
Ew0R
Between 1942 and 1963, twanty-nine (29) nurse advisors provided
a total of 69 years of service in Ecuador. Twenty (20) of these
nurses worked as public health nursing advisors with the Servicio;
nine (9) directed or taught in schools of nursing and assisted with
development of organized nursing services in hospitals utilized for
student practice.
A Division of Nursing was established within the Servicio, with
a USAID nurse advisor serving as the first Chief Nurse. Ecuadorian
nurses were brought into the department and trained in public
health nursing. Auxiliary nurse training programs of 3 to 8 months
duration were organized by USAID and PASE/WHO nurse consultants.
Assistance was given in developing teaching materials and a
standard procedure manual and record forms for health centers.
Consultation on curriculum development and organization was given
to the faculty of the National School of Nursing and St. Vincent de
Paul School of Nursing in Quito. Fellowships were provided by USAID
and Rockefeller Foundation for 25 selected Ecuadorian nurses to
obtain post-basic preparation in public health nursing, nursing
education or nursing service administration. In 1958, the
Ecuadorian nurses were helped to organize a National Nurses'
Association. When AID assistance in health was discontinued in
1963, major problems remained. Recruitment 6f candidates for
nursing schools was still a problem because limited budget for
health services made it difficult for those who graduated to find
salaried employment. The responsibility for coordination of medical
care programs and public
health was then in the Department of Health, placed within the
Ministry of Labor and Welfare. No Norsing Division existed, no
nurse advisor was on the staff at the national level. In 1964,
under contract with AID, St. Louis University established a 4-year
university level nursing program at the Catholic University of
Ecuador in Quito.
EL SALVADDR
Assistance to the Ministry of Health in the development of
nursing in El Salvador was provided from 1943-1964. During that
period, 14 USAID nurses served a total of 25 years. Their primary
contribution was in the field of public health, beginning with
operational support for public health nursing services and
gradually changing over to consultation service on the national,
regional, and local levels. For a period of time AID supplemented
the salaries of Ministry of Health nurses working in public health.
Twelve (12) fellowships for post-basic preparation in public health
nursing were granted to nurses who had administrative and
supervisory responsibilities in the larger health centers.
Assistance was also given to 2 schools of nursing to strengthen
basic nursing education and to help integrate public health nursing
in their curricula. USAID supplied 17 participant grants to prepare
faculty members. It financed construction of the National School of
Nursing in Santa Ana in 1954, and turned it over to the Ministry of
Health in 1955.
El Salvador has a National Nurses' Association that is not yet a
member of the ICN. In 1962 USAID provided consultation to this
Association on legislative and organizational matters. PASB/WHO and
the Kellogg Foundation have also given considerable assistance to
the development of nursing in El Salvador.
GU1ATEMATA
USAID nursing assistance to Guatemala extended from 1943-1960.
During this period 13 nurse advisors served a total of 32 years.
Principle aid was given in establishing and operating rural health
centers, maternal-child health clinics, and setting up 5 mobile
health units, training of public health personnel to vqrk in rural
areas, strengthening
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GUATEAIA (Continued)
the public health program at the national level in support of
nursing, and strengthening the educational program of the National
School of Nursing.
From 1942*1955 USAID nurses functioned as Director of the
National School of Nursing then shifted to an advisory role for
another 4 years. PASB/WHD nursing advisors cooperated with them
from 1952 onward, in reorganizing the School, revising its
curriculum, providing in-service training fo: faculty, developing
auxiliary nurse training, and improving the clinical areas for
student practice in the Roosevelt Hospital. Both agencies furnished
fellowships for Guatemala nurses to obtain advanced preparation in
nursing education, hospital nursing service; and publit health
nursing. USAID nursing advisors assisted the nurses of Guatemala in
the development of a Nursing Council and a Nursing Association. The
Council, created in 1960, is advisory to the Ministry of Health on
matters necessitating legislation to improve nursing service and
education. When USAID assistance in health was phased out in 1961,
PASB/WHO nursing advisors continued to give consultation to the
Nurse in the Ministry of Health and to provide advisory services in
public health and in professional and auxiliary nursing
education.
HAITI
In 1942 the United States Government and the Government of Haiti
signed an agreement to establish a cooperative Public Health
Program (Servicio) within the Haitian Ministry of Health. From that
time until 1962, fourteen (14) USAID nurses advisors provided 29
years of service. They helped to establish and operate health
centers, to prepare nursing personnel to work in them, and to
reorganize and strengthen the basic nursing education program in
the National School of Nursing. Nurse advisors assisted in the
operation of a school to train nursing auxiliaries to work in rural
health services, conducted on-the-job training of all nursing
persdnnel in the centers, and aided in integrating public health
nursipg in the nursing school curriculum. Eight (8) Haitian nurses
received participant training grants to study public health nursing
in the United States and returned to assume responsibility for the
continued development of nursing services.
In 1954 a nursing section was organized in the Department of
Public Health. PASS nurse advisors assisted the Chief Nurse in
developing this Section, and together with AID nurse advisors,
helped the nursing section develop a nation-wide program for
training midwives in the rural areas, In 1958 it was proposed that
the Ministry of Health assume responsibility for the school for
rural health nursing. auxiliaries. By 1962 Haiti had 6 health
centers with budgeted and filled positions for 50 public health
nurses. An AID nurse served as Director of the National School of
Nursing froT 1942 to 1951 when a Haitian nurse was appointed to
this position. ;both AID and PASB provided participant training
grants to prepare nurse faculty, and by 1961, six (6) full-time
nurse instructors had advanced preparation. Haiti now has 2 schools
of nursing that require 11 years of basic education for
admission.
USAID assistance in nursing to Honduras extended fro 1943-1961.
Five (5) nurse advisors worked 17 years with the Setvicio, helping
-to establish health services in the 7 health districts throughout
the country. Both AID and PASB provided technical assistance to
national nurses to up-grade the performance of auxiliary nurses in
the rural health programs; and fellowships for advance preparation
in public health nursing, nursing education, and nursing service
for national nurses in key positions.
In 1961, only one (1) school of nursing in the country met
minimum criteria established by PASB for inclusion in the Directory
of Schools of Nursing in Latin America. The USAID nurse advisor
assisted in the selection of students for this school and for study
of basic nursing in nearby countries as recipients of scholarships
from the governments of El Salvador, Guatemala, Mexico, Panama, and
Puerto Rico.
The USAID health program in Honduras was phased out in 1961.
Since that . time, with assistance from PAS nurse advisors, a
Hurses' Association has been established, a national nurse has been
appointed Chief Nurse in the Ministry of Health, and in 1966 a
university level program in nursing was started.
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bMMCO
USAID nursing assistance in Mexico extended from 1947-1957.
During that period, 5 nursing advisors served a total of 20 years.
Assistance was given in the organization of a Nursing Division in
the Ministry of Health and preparation of Mexican nurses to carry
out its responsibilities. By 1957, this Division had a Chief Nurse,
6 public health nurse instructors, and 2 instructors in nursing
education to provide consultation to the states.
Public health nursing programs were developed in selected rural
areas, with Mexican nurses in charge, 72 nurses were granted USAID
scholarships to study public health nursing in the School of Public
Health, Mexico; 2 nurses to study in Chile, 2 in the United States,
and 135 in Regional Centers in Mexico. Assistance was provided for
the instructors' course offered at the Division of Nursing of the
Graduate School of the University of Mexico, starting in 1957.
Forty-three (43) scholarships were granted to nurse instructors for
study in this course. USAID supplemented salaries for
facultymembers and provided improvements in physical facilities at
the National School of Nursing. At the time USAID nursing
assistance was discontinued, Mexico had a well established Division
of Nursing in the Ministry of Health; a National Nurses'
Association with membership in the International Council of Nurses;
6 post-basic programs of 6-10 months' duration in nursing
education, nursing service and public health; and 14 of its 88
professional Schools of Nursing met minimum criteria necessary to
be listed in the Directory of Schools of Nursing in Latin America.
During this period, assistance to nursing in Mexico has also been
given by the Pan American Sanitary Bureau/world Health Organization
and the Kellogg Foundation.
NICARAGUA
USAID nursing assistance to Nicaragua began in 1943 shortly
after the Servicio was established and ended in 1963. Consultation
services were not continuous during this time, however. Twelve (12
nursing advisors served a total of 15 years between 1943 and
1948;
one (1) served frot 1953 to 1954; and two (2) from 1960 to 1963.
The principle activities of the USAID advisors were in the fields
of public health nursing and nursing education. They assisted in
the establishment of a Section of Nursing in the Ministry of
Health, acted as consultants to the Chief Nurse, and took an active
part in helping to improve health services throughout the country.
Twentytwo (22) AID participant grants enabled 12 nurses to study
public health nursing in the United States and 10 to study in
various. Latin American countries. In 1943, two (2) AID nurse
advisors assisted the Chief Nurse in the Ministry to establish the
National School of Nursingin Managua. It is I of 5 diploma schools
in the country--the other 4 are small church-sponsored schools--and
had a total enrollment of 69 students in 1963. PASB/WHO as well as
AID has provided fellowships to prepare instructors.
An auxiliary nursing program was started in Managua General
Hospital and in-service education programs for auxiliaries in rural
areas were introduced by USAID advisors. These programs have been
continued after AID assistance was phased out in Nicaragua.
USAID assistance in nursing extended from 1951 to 1964. During
that period, 7 nurse advisors gave 28 years of service to help
up-grade the School of Nursing at Santo Tomas Hospital. and to
improye nursingpractice at the Santo Tomas, Nicolas Solano, and
Psychiatric hospitals where the students obtained practical
experience. The Director, and 6 faculty meers from the School of
Nursing received AID participant grants for advanced preparation in
the United States; 7 additional nurses received grants to study
nursing service administration.
Staff education programs in the School and in-service training
programs for all nursing service personnel in the 3 hospitals were
established; 1,800 books were supplied to the Nursing School
library from the Regional Technical AID Center in Mexico. Most were
in Spanish.
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PMANA (Continued)
AID nursing advisors assisted the faculty of the School of
Nursing to establish a Department of Nursing Education in the
University of Panama in 1963. Its purpose is to provide post-basic
courses for graduate nurses.
The Panamanian Nurses' Association, a member of the
International Council of Nurses, conducted in 1962 the first
International Congress of Nurses for the Americae. Over 600 nurses
attended.
Twenty-two (22) USAID nurses served a total of 46 years in
Paraguay between 1942 and 1965. Principle efforts were devoted to
the development of public health nursing services in rural areas,
and improvement of basic nursing education for professional nurses.
For 15 years, USAID nurses working in the Serviclo assumed
responsibility for the operation of four major health centers. They
organized the nursing services, recruited and provided on-the-job
training for both professional and auxiliary nursing staff, and
supervised their practice. Later, their activities shifted to
development of services on a regional basis. A demonstration center
was created at Encarnacion, with organized training programs for
auxiliary personnel to staff health centers throughout the
region.
A nursing section was established in the Ministry of Health and
Social Welfare in 1955. Consultation to the Chief Nurse has been
provided by PASB/WHO nursing advisors who, in cooperation with
USAID nurses, have assisted her with overall planning for
deVelopment and coordination of the country's nursing and midwifery
services.
Assistance to nursing education began in 1952 when the Andres
Barbero School of Nursing was reorganised into a three-year program
accepting only high school graduates. From 1957 onward, through
AID/University of Buffalo contracts, continuous nursing advisory
services have been provided to this institution. In 1963 it
became
a 4-year university level program and was ineorporated into the
National University of Asncion. Considerable assistance in the
development of the School was also provided by the W.K. Kellogg
Foundation.
PERU
Between 1942 and 1963, twelve (12) UAID nurse advisors worked a
total of 29 years with the Servicio in Pern. They assisteo with the
organization of public health nursing services, pioneered In the
conduct of formal courses of training for hospital and public
health auxiliary personnel; taught public health nursing at the
Rimac Health Center-a demonstration unit established in 1945 by the
Servicio; -and aided with the establishment of a nursing section in
the Ministry of Health in 1951. USAID and PASB/WHO provided
fellowships for national nurses to obtain preparation in public
health nursing--the majority at Rimac and 11 in the United States.
By 1963, an Institute for Post-Graduate Nursing was established,
with PAHO assistance, under the auspices of the Ministry of Health.
For the first time, advanced preparation in public health nursing,
nursing education, and administration of nursing services became
available to national nurses in their own country. Between
1961-1963, USAID nursing advisors assisted with improvement of
nursing services in hospitals,
USAID nursing assistance to Surinam, given from 1957-1962, was
provided by 2 nursing advisors who served a total of 5 years just
prior to the phase-out of the AID health program. At the request of
nursing leaders in the country, they focussed their efforts on
aiding with the development of public health nursing services in
the Ministry of Health, and 2 nurses had U.S. study in public
health nursing. Records available concerning AID activities are
incomplete, but it appears that development of a denonstration
health center in which personnel could be trained was given high
priority.
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URUGUAY
USAID provided nursing assistance to Uruguay from 1944-1958.
During this period. 6 nurse advisors served a total of 12 years.
Four (4) advisors concentrated their efforts on assisting Servicio
nurses with the development and execution of a national public
health nursing program. Five.(5) demonstration health centers were
developed, training courses for assistant public health nurses
instituted, and inservice training for graduate nurses given. Three
(3) Uruguayan nurses received 1-year AID fellowships to study
public health nursing in the United States; three (3) received 2
months' training in public health nursing in Chile. Two (2) nursing
advisors assisted the 2 professional nursing schools with
organization, curriculum planning, development of courses, and
preparation of faculty. Fourteen (14) faculty members from the
University School of Nursing and 3 from the Carlos Nery School of
Nursing received 1-year participant training grants for study in
the United States.
Uruguay's National Nursing Association was admitted the full
membership in the International Council of Nurses in 1957. USAID
nurse advisors worked with Association members on problems of
organization, education, and legislation. Rockefeller Foundation
and PASB/WHO have also provided training funds and advisory
services to nursing in Uruguay.
VENEZUELA
Nursing assistance to Venezuela was confined to the field of
nursing education. Three (3) USAID nurse advisors provided 9 years
of service between 1945-1955, to help up-grade the National School
of Nursing to serve as a "model" for other nursing schools in the
country to follow. Equipment for the School and fellowships for
faculty memhers were contributed by the Rockefeller Foundation. The
USAID nursing advisors also gave consultation on nursing service
organization and assisted with the development of an auxiliary
nurse training program.
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STATUS * 1942
UNITED STATES
ACTION
AGENCY FO NENTOA
TAKEN BY 1SAID 1942-1963
EEOiR USN NRVA
STATUS - 1963 ACTION TAKEN BY OTHERS 1
POPULATION:
NUMBER OF NURSES:
2,704,165
30
POPULATION: 3,462-,000 (estimated)
NUMBER OF NURSES: 284
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NUMBER OF AUXILIARIES; Unknown NUMBER OF AUXILIARIES: 277
TOTAL NURSING PERSONNEL: 30 TOTAL NURSING PERSONNEL: 561
NURSING PERSONNEL POPULATION:
PER 1:100,000
NURSING PERSONNEL POPULATION:
PER 16:100,000
COUNTRY AREA: 1,098,580 square kilometers.
MINISTRY OF HEALTH: MINISTRY OF HEALTH:
* Known as the Ministry of Hygiene Public Health.
and a United States Government and the Govern-ment of Bolivia
signed an agreement in 1942 to establish a cooperative public
health program. This organization of two governments was called the
Servicio.
* Organizational structure Oery much the same.
remains
* The aim of the Institute of Inter-American Affairs (IIAA)* and
Servicio program was to: - Recognize and help solve public
health
problems; - Strengthen the public health progrms
in the national administration. -
OVERALL HEALTH PLAN: OVERALL HEALTI PLAN:
* Unknown. a 1958 sanitary code guide for organization in the
Ministr. No concrete health plan.1
re
'is now the United States Agency for International Development
(USAID).
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2
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
HEALTH SERVICES PROVIDEDf HEALTH SERVICES PROVIDED:
* Services vwere curative only. a Servicio has assisted in
establishing: - 16 health centers: - sanitary engineering programo;
- public health ursing progran; - training of health personnel; -
occupational health program; - health education program; -
nutrition program; - statistical program.
Effort toward preventive services as veil as curativlin ill
fields of public heal
NURSES IN THE MINISTRY: NURSES IN THE MINISTRY:
o None. *
*
Servicio chief nurse was a national nurse and the second
participant to receive training in her country.
1960 Servicio Nursing, Division of Technical Services, Ministry
of Public Health officially became the fu 1 responsibility of the
Ministry of Health. .U)
* Director of Nursing Division, Ministry of Public Health:
Organization -- Assistant Director; - Nursing Education Advisor; -
Rural Health Serviceq Advisor; - Advisory Committee.2 -
Pan American Sanitary Bureau/World Health Organization
(PASI/WHO)2 consultants assigned to Nursing Division to advise on:
- Schools of Nursing; - Health Serv c Projects. P
ADVANCED EDUCATIONAL LEADERSHIP GROUP:
TRAINING FOR ADVANCED EDUCATIONAL LEADERSHIP GROUP:
TRAINING FOR
* None. * Advanced preparation for educational training programs
for future Ministry of Health (MOH) nurses began in 1957:
Number Field Man Years
e Two returned to the Ministry of Health as chief nurse and
supervisor. Two tt e y Center-supervisors.
4 Public Health Nursing 8 13/
PUBLIC HEALTH DEPARTMENT: PUBLIC HEALTH DEPARTMENT:
* Health Department under the Director General.
*
*
Servicio type public health cooperative func-tioned in an
operational capacity,
U.S. contribution, 1942-1952-- 2,232,393.S5 to joint funds for
operations. -
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a
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The Servicio was integrated into the Ministry of Health in
19621963. - - -
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STATUS - 1942
uITED STATES AGENCY FOR NTERNATIONAL DWEIDFMHT NURSING- IN
BOLIVIA ACTION TAKEN BY USAID 1942-1963 STATUS - 1963 ACTION TAKEN
BY
3
OTHERS
PUBLIC HEALTH NURSES IN THE COUNTRY: PUBLIC HEALTH NURSES IN THE
COUNTRY:
V
* None. . Public Health Nursing initiated in 1942 under the
Servicio and directed by ICA consultants until 1954.
* Problems: - lack of prepared personnel; - high cost of living;
- lack of opportunity for improvement; - diffict r nrtation; - low
salarie.
* Public Health Nursing Department: - Chief Nurse;- Assistant
Chief Nurse; - Nursing Education Advisor; - Rural Health Services
Advisor. 14/
* Total number of public health nurses not known. Aare that both
training and nursing being done a the graduate and auxiliary
levels.
* First 4 nurses employed by the Servicio for health centers
taught procedures by nurse advisors.
NURSES PREPARED PROGRAMS:
IN ACADEMIC PUBLIC BEAIU NURSES PREPARED PROGRAMS:
IN ACADEMIC PUBLIC HEALTH
* No infornation. * A total of 63 nurses trained in Public
Health 14uzsing from 1942 to 1952 by IIA nurse advisors.
. * Three of the group are still working in Boliviaas public
health nurses.
Public Field Man Years
6 Public Health Nursing 4 - 9 mos.
* Scholarships were provided by the Servicio nd IIAK in 3rd
countries.
-
4 UNITED STATES AGENCY FOR INTERNATION4AL DEVELOPMENT NURSING IN
BOLIVIA
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
PUBLIC HEALTH NURSING SERVICES PERFORMED:
V No information. * uSIIAA Public Health Nursing Advisors:
Number Field - Years
14 Public Health Nursing 29
* 1957 Servicio Nursing Staff: - 22 public health nurses; -
17,graduate nurses; - 16 auxiliaries (trained); - 17 auxiliaries
(untrained); - 4 nurse-midwives.
* Technical support given in public health nursing: -
organizing, supervising, evaluation; - provide adequate public
health nursing
service; - train personnel; - taught public health nursing 17
the
National School of Nursing; -- assist in preparation of
inrservice
programs; - assist with staffing rural mobile units; - assist in
setting up various types of
clinics; - conduct midwifery refresher courses for
auxiliary midwives; - assist with basic public health carri
calu in the school of nursing for an integrated program;
- assist training committee to establish and revise policies for
participant study in the United States and 3rd countries;
- changes in clini 3 organization of public health nurning.
-3
PUBLIC HEALTH NURSING SERVICES PERFORMED:
* 1960 Department of Nursing reorganized.
* Public Health Nursing in the health centers emphasized: -
Maternal and Child Health; - Tuberculosis and Venereal Disease
Control; - Immmnizations against the comnuni
cable diseases; - Nursing includ*
- home visits - individual conferences with
patients at clinics; - mass served as part of the
health team in community organizat ion dqvelopmen t
-telpmnactivities.
-
UNITED STATES AGENCY FOR INTENATIONAL DEVELOPMENT NURSING IN
BOLIVIA 5 STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS -
1963 ACTION TAKN-BY OTHERS
GUIDELINES PRACTICE:
TO PUBLIC HEALTH NURSING .
GUIDELINES TO PUBLIC HEALTH NURSING PRACTICE:
* Unknown. * USIIAA nurse advisors assisted in preparation of
procedure manual which was sent to all 15 health centers.
a . Procedure Manual is still being used in" the Mini y of
Health.
TRAINING INSTITUTIONS: TRAINING INSTITUTIONS:
Professional Nursing:
Schools of Professional Schools Nursing:
of
* National School of Nursing organized in 1941 by first Bolivian
nurse participant who had had 3rd country training. Close4 in 1941.
Reepened in 1942.
*
*
In 1947 the Servicio provided 10 fellowships (becas) for girls
to enter school of nursing in the Anglo American Hospital in Lima,
Peru.
Servicio advisors taught Ill student-nurses courses in public
health nursin It the National School of Nursing from
1949-1957.-0
* 2 recognized schools of nursing: - National School of
Nursing--La Paz; - Clinica Americana--
La Paz.
* 12-20 students are admitted annually to each of the 5
schools.
* Other schools of nursing are: - University of Sucre--
opened in 1960; - University of Tarija; - Catavi School of
American Red Cross provided 37 becas for nurses trailn g in
Lima, Peru, from 1938-1946. "
METHODIST CHURCH:
e I school of nursing--Clinica Americana was organized 1938.
Recognized by law in about 1940.
* Approximately 82 students have graduated in 16 years
(1952).
* American Red Cross fellowships for participant to study in
Panamat
Number| Field Man Years
Nursing. U111 1 Nursing Education1 1n,
* CARE Organization committed to supply librai, to National
School of Nursing. -
* PASB/WHO sent two nursing education consultants to assist in
the reorganization oI the National School of Nursing. 17
-
UNITED STATES AtlDTC FOR TINATTONAT. DEmyliTMRf NHRETNP. TN
BOL.TVTA .STDTI66
, STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS 1963
ACTION TAKEN BY OTHERS
SCHOOLS OFFERING -ADVANCED SCHOOLS OFFERING ADVANCED
PREPARATION: PREPARATION:
* None. * None. i7
TRAINING INSTITUTIONS (Continued) TRAINING INSTITUTIONS
(Continued)
Practical Schools Programs; Practical Schools Programs Auxiliary
Programs: Auxiliary Programs:
* None * Servicio was instrumental in starting the a 3 auxiliary
schools-schools at Oruro, Riberalto, and La Paz. - 2 schools in
Oruro and
Riberalto are connected * Servicio nurses taught 40 courses
-in
public health nursing to auiliary nurses, with religious
order;
- 1 school in La Paz under between 1953-1957. MDH.
* Also taught 15 classes in 1955 auxiliaries for the Red
Cross.
to nurse 10
* All 3 schools yse the same curriculum. li
.Length of course-- 12 months - at Riberalto--6 months
others.
* Educational requirements are: - 3 yearsof schooling for .
Oruro; -- 6 years of schooling for
Riberalto and La Paz. -
* Auxiliary schools are now the responsibility of the Ntursing
Division, Ministry of Health.
-
7 ITNTTRI1 s'I'A'n ACnJCV nfl ~'rgR~Mrtn~3At ntvrInMrn flvgTr
flu TanT~UTS
STATUS - 1942 ACTION. TAKEN BY USAID 19.42-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
MIDWIFERY SCHOOLS (Programs): MIDWIFERY SCHOOLS (Programs):
0 Unknown. * Servicio nurses felt there was need for in * Woman
wishing preparation in struction in midwifery in 1954. midwifery
may attend the
following schools: * IIAA Nurse Advisors: - University of
Sucre--
Number Field Man Years students are prepared be nurse
midwives;
to
I Midwifery 3 22/ - University of Tarija-1963 prepared students
in either nursing OR
* Advisor in midwifery began the course December 1957-May 1958
Concepts upon which the rural midwives' school was based; - Nursing
and midwifery closely related;
midwifery. Plans are to reorganize the course into
nurse-r9dwifery training. -*
- Auxiliary midwives and auxiliary nurses * Medical Division of
the MOH should be trained in both fields. administers midwifery
activ
ities. Supervision is done by medical directors at both the
regional and local levels within the hejsb units in the field.
-
e Seven students in the group who were suc * Santa Cruz Hospital
wished to UNICEF contributed cessful and their fair to
excellent.
performance Ages were
varied from 20-35 years.
continue the auxiliary mid-. wifery training against great odds.
Advised by
midwifery bags to the 7 graduate of the course. *
* Course given in the Maternity Hospital Santa Crus. Training
included: - 4 months of theory with practice in prenatal
clinic;
- 4 months of practical experience;
in
the
nurse-mfdwife to discontinue course as there was no trained
counterpart to teach the program and the 9 would be no supervision.
-
- examinations given weekly and at the end of each course
subject.
* Consultant taught 16 Faduate nurse-midwives between 1957-1959.
22
I_________________ ___________ ________
-
- UNITED STATES AGENCY R I TINALDEVlFlMNT 1URSING .IN BOLIVIA
8
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
PRACTITIONERS PREPAREDh WITHIN THE COUNTRY PRACTITIONERS
PREPARED WITHIN THE COUNTRY:
* Nurses graduated annually - unknown.
* Auxiliary nurses - unknova.
* Nurses graduated annually - 25-30 nurses graduated from the 2
recognized schools.
* Auxiliary nurses - unknown.
18
* Nurse-midwives - unknown. * Nurse-xidwives - unknown.
* Auxiliary midwives - unknown. * Auxiliary midwives -
unknown.
TOTAL NUMBER OF PRACTITIONERS: TOTAL NUMBER OF
PRACTITIONERS:
* Graduate nurses--estimated to be 30 nurses. (li 1;ed.
education and experience).
* Graduate nurses--577 (active).A/
" Auxiliaries, - unknown., Auxiliaries - Active: -
untrained------------- 3-5 months' training - - -- 6 months'
training - - - -
Total - - - -
284 33 44
561 -
* Midwives - unmown. * Midwives - 32 (qualified).
ADVANCED FACULTY:
PREPARATION FOR NURSING SCHOOL, ADVANCED FACULTY:
PREPARATION FOR NURSING SCHOOL
o Unknown. . Basic program at national school is directed by WED
consultant. Several instructors have had 3rd country preparation of
one year. AU
PASB/WRO - It is reported that 4 scholarships per year were
given for faculty preparation in 3rd country.
Two instructors have Masters degrees at Clinica 7ricana School
of Nursing.
-
______________
9 vUaTau ODAT D AGENU FOR INERNAT.N1AL DAVELfMENT NUKING 1
BULIVIA STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS -
1963
NURSE-DIRECTORS OF SCHOOLS: NURSE-DIRECTORS OF SCHOOLS:
a Unknown. * The National School of Nursing had a natiqual nurse
as director.
* Physicians are directors of the schools in Sucre and
Tarija.
* School in Catavi has an instructor for the director. 2
REQUIREMENTS FOR SCHOOL CURRICULUM: REQUIREMENTS FOR SCHOOL
CURRICULUM:
* Unknown. * Standard curriculum established for all schools of
nursing, however, schools in Sucre and Tarija are just introducing
the curriculum in 1963, emphasis on liberal arts.
* Public Health inte 1ated./
LENGTH OF PROGRAMS: LENGTH OF PROGRAMS:
a Unknown. * National School Tf1 Nursing 4-year program. R
PREREQUISITE EDUCATION: PREREQUISITE EDUCATION:
e Unknown. * National School students must have high school
education: - 18 years of age; - physical examination; -
psychological testing; - general knowledge ex uation; - personal
references.
* Ece ti to the abu i ture
take psychogocal testing. il
ACTION TAKEN BY OTHERS
The Clinica Americana School of Nursing has an Americaq nurse as
Director.-'
Clinica Americana School used the standard curriculmn for
nursing in 1938. Uses established curriculum of 1963.
Public Health integrated.fl 1
Clinica Americanaschool 4-year program.
Clinica Americana School students must have high school
education. The requirements are same as for National School.
-
UINITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT NURSING IN
BOLIVIA 10 STATUS - 1942 ACTION TAKEN BY 11SAID 1942-1963 STATUS -
1963 ACTION TAKEN BY OTHERS
WRITTEN GUIDELINES: WRITTEN GUIDELINES:
P None. * None.
&. STANDARDIZATION PROCEDURES-- STANDARDIZATION
PROCEDURES--NATIONAL EXAMINATION: NATIONAL EXAMINATION:
* None. * Not known.
* All 5 schools give certificates in nursing Director of Nursing
at upon completion of the 3-year program and the Clinica Americana
1 year of graduate nursing in a provincial places her graduates
after hospital. The Director of Nursing, MOH, consultation with the
places all the graduates for four of the Nurse Director, MOE.
schools of nursing. Nurses receive their license from MOH and have
with other Latin American
reciprocitycountries. /
* Government nursing code of standards written by others. Nurses
were not consulted nor ed to participate in its formation. D
CRITERIA OF A GOOD SCHOOL: CRITERIA OF A GOOD SCHOOL:
* Unknown. * The 2 recognized schools of nursing meet the
criteria as tablished by PASB/WHO set up in 1961.
PROFESSIONAL NURSING ORGANIZATION: PROFESSIONAL NURSING
ORGANIZATION:
s None. * Established in 1963. Do not have ION membership.
Branches Santa Crus and Oruro.
in MI
Cochabamba,
NURSING LIThRATURE: NURSING LITERATURE:
a Unknown. * No information.
NATIONAL EMPLOYMENT CATEGORY: NATIONAL EMPLOYMENT CATEGORY: a
Unknown. e Nursing positions within the MOE.
-
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
UNITED STATES AGENCY POR INTERNATIONAL DEVELOPMENT NURSING IN
BOLIVIA
- ACTION TAKEN BY OTHERS 11 /
HOSPITALS--DEPARTMENT OF HOSPITALS: HOSPITALS--DEPARTMENT OF
HOSPITALS:
* Unknown. * 3B General Hospitals -6 Maternity Hospitals -3
Tuberculosis
Hospitals.- - -1 Psychiatric Hospital-
465 beds 230 beds
329 beds 290 beds, V
NURSING SERVICE CONSULTANT: NURSING SERVICE CONSULTANT:
* Unknown. * USAID gave participant training:
Nimber] Field Man Ye
1
" It is reported that nursing care is given by auxiliaries with
graduate nurses supervising.
* Present status of nursing in Bolivia: - shortage of well
prepared personnel
due to great turnover and exodus outside Bolivia;
- competitive agencies (private and international) offer better
salaries and more security;
- doctors make all decisions on nurs
. In the department of nursing, MDH, there is a Rural Health
Services Advisor. The diagram seems to indicate that she has
jurisdiction over and responsibl1 ity to
hospitals and health centers. -)
* No special incentive has been offered to keep their nurses.
1I
o Nurses are trying hard to get salaries raised. -1/
ing matters; - hurses do not have prestige
professional group. .I as a
-
UNITED STATES AGENCY FOR INTENATIONAL DEVEIOPMENT NURSING IN
BOLIVIA 12
REFERENCES
1. WORLD HEALTH ORGANIZATION. First Report on the World Health
Situation, Geneva, 1954-1956.
2. . Second Report on the World Health Situation, Geneva,
1957-1960.
3. . Directory of Schools of Nursing in Latin America, Pan
American Sanitary Bureau, Regional office of the World Health
Organization, Washington, D. C.
4. . Published Report of Questionnaire in Nursing in Bolivia,
Pan American Sanitary Bureau, Regional Office of the World Health
Organization, Washington, D. C.
5. . Director of Schools of Nursing, 1961, Pan American SaniEary
Bureau, Regional Office of the World Health Organization,
Washington, D. C.
6. . Criteria for the Schools of Nursing in Latin American, Pan
American Sanitary Bureau, Regional Office of the World Health
Organization, Washington, D. C.
7. INSTITUTE OF INTER-AMERICAN AFFAIRS. United States Public
Health Service, Ten Years of Cooperative Health Programs in Latin
America, Evaluation, C0.. Rowe, Acting President, Institute of
Inter-American Affairs.
8. UNITED STATES PUBLIC HEALTH SERVICE. Foreign Women
Participants Program in the United States, 1950-1965, issued by the
Office of International Health, Division of Education and Exchange
Branch.
9
9. UNITED STATES AGENCY FOR INTRERNATIONAL DEVELOPMENT. Report
on Conference on Nursing in Bolivia. Catherine M. Kain, Nursing
Consultant, June 19, 1963, La Paz.
10. . Resume of Nursing in Bolivia, 1942-1962, Catherine M.
Rain, Nursing Advisor, Washington, D. C.
11. . Report on Nursing in Bolivia, following Conference with
the Director of Nursing, Ministry of Health, Catherine M. Rain,
Nursing Consultant, Washington, 1963.
12. UNITED STATES INTERNATIONAL COOPERATION ADMINISTRATION.
Information in Conclusions Reached at Public Health Technical
Conference, La Paz, February 20, 1960, ICA/TOICA-A-1215.
13. 1. End of Tour Report, Catherine D. Berkheimer, Public
Health Advisor, April 26, 1960.
-
13 UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT NURSING IN
BOLIVIA
REFERENCES
14. UNITED STATES INTERNATIONAL COOPERATION ADMINISTRATION.
Report on Nursing in Bolivia. Catherine M. Kain, Nursing
Consultant, La Paz, 1960.
15. . Brief Statement of Activities and Objectives of SCISP by
Ray M. Hill, Director, United States Overseas Mission/Bolivia,
TOICA-A-565, October 20, 1959.
16. . Trip Report to Bolivia to Evaluate Conference Draft of
Report, Catherine M. Kain, Nursing Consultant, March-April
1957.
17. . Consultation Visit, March-April 1957, Anna M. Matter,
Regional Nursing Consultant.
18. . Nursing and Nursing Education in Bolivia, 1960, Catherine
D. Berkbeimer, Public Health Nursing Consultant.
19. INTER-AMBRICAN COOPERATIVE PUBLIC HEALTH SERVICE. Report of
the Evaluation Conference, March 11--April 5, 1957, La Paz, United
States Overseas Mission.
20. UNITED STATES INSTITUTE OF INTER-AMERICAN AFFAIRS. Puli-
Health Nursing in Bolivia. Charlotte C. Thomny'
-
14
NURSING ADVISORB--BOLIVIA-1942-1963
Rosina Romero 1942-1944 p
Emilia Saucedo - - - - - - - - - 1943-1944
Clare Wangen - - - 1943-1944
elan Brazonis - - - 1944-1946
Catherine Drackert - 1944-1945
Ruth lyden - - - - - - - - - 1945-1946
Charlotte Thompson - - - - - - - 1946-1950
Helm Boehm - - - - - - - - - 1947-1948
Martha Caret - . - - 1948-1949
Harlinda Castro - - - - - - - - 1949-1952
Cruz Bair - - - - - - - - - 1952-1955
Mary Luvisi - - - - - - - - - 1955-1957
An Johanneson - - - - - - - - 1956-1959
Earline Finnerty - - - - - - - - 1957-1958
Catherine Derkhaier - - - - - - 1958-1963
TOTAL MAN-YEARS OF NURSIEG TOTAL NURSE S ASSISTANCE TO THE
COUNTRY
15 32
-
15
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
POPULATION: 41,236,315 L4/ POPULATION: 79,800,000
NUMBER OF NURSES: 300 NUMBER OF NURSES: 6,054 l
NUMBER OF AUXILIARIES: 38,429 (untrained>
t1WRNUMI.RJL*hAX1ES: 7,000
TOTAL NURSING PERSONNEL: 38,729 TOTAL NURSING PERSONNEL:
13,054
NURSING PERSONNEL POPULATION:
PER 94:100,000
NURSING PERSONNEL POPULATION:-
PER 16:100,000
COUNTRY AREA: 8,513,844 square kilometers.
MINISTRY OF HEALTH: MINISTRY OF HEALTH:
a The Minister of Health conducts the affairs of the Ministry
with the advice of the Cabinet and a National Health Council. The
Ministry comprises the following Departments:
- Child Health; - Administration; - Health; - Osaldo Cruz
Institute.
In addition, there are the following Services:
- Health Statistics; - Documents Services; - National Insurance;
- Special Public Health Cooperative Service (ICA). Z/
a The United States Government through the Institute of
Inter-American Affairs (IIAA) in cooperation with the National
Health Council of Brazil assisted in organizing and establishing
the Servicio Especial de Salud Publica (SESP) in 1942. The aim of
SES8 was to plan and assist in the implementation of the plans
through expenditures, technical support, and con-struction. The
overall goal was to reenforce health services at the National level
of the government. SESP assisted the Minister of Realth i4
developing a national health plan. 21 .
-
e The organization and administration remain generally the same
as described. The federal constitution gives the individual states
autonomony with respect to structure and administration of their
services, This produces some difficulty in the coordination of the
country's health services.
-
16
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
NURSES IN THE MINISTRY OF HEALTH: NURSES IN THE MINISTRY OF
HEALTH:
* Brazil established the first Nursing Bureau within the
National Department of Health in the world. Bureau ha4 equal rank
with all the other bureaus, 15
* Main function of the Nursing Bureau was to coordinate the
activities of the public health nurses in patient care. 1/
a The USIIAA nursing advisors worked closely with the Nursing
Division in the SESP. They also acted as consultants to the nursing
sections in the various Ministeries.
a
v
Ministry of Education had the Nursing Section.
Nursing personnel serving in the headquarters and some states
number 13. 1
By 1950 the-Ministry of Education had a nursing section which
made a survey of Brazilian nurses and present employment.
Kellogg Foundation rendered assistance to nursing in
Brazildetails unknown.
Rockefeller Foundation was asked by the General Director of the
Rational Departnent of Health to survey the communityneeds and to
recom-
V
n Nurses vrking with the Nursing Section in the Ministry of
Health (Mol) are nany and their duties extend to the
mend a program to the government for public health nursing
development.
State Health iiiapetments.A15/
PUBLIC HEALTH DEPARTMENT; PUBLIC HEALTH DEPARTMENT:
* Federal activity in the health field in Brazil is in the
control of diseases which cross state boundaries, notably endermic
and epidemiediseases. The most important unit within the Federal
govern-ment, MOR, is the Department of Rural Endemic 3s
a The IIAA implemented the cooperative health program in Brazil
through an administrative device known as SESP, see 'Ministry of
Health."
* See colun 1 for Federal Activity of the National Department of
Health.
a onher activities which are under the National MOFnt - Specific
disease control aiseases programs,
- Advising state health Departments on disease control;
- Malaria eradication; - Control of registration; training
standards; and approval doctors, dentiats,and nurses. 1
af
15 of 22 states hoer health programs.
public g ns
* By 1959 the countFy health program had been carriedoout
programinBrazilthroughanadmi iworkin for S.
-
UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT NURSING IN
BRAZIL 17
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
T PUBLIC HEALTH NURSES IN THE COUNTRY: PUBLIC HEALTH NURSES IN
THE COUNTRY:
* Fifty percent of the graduate nurses, approximately 400, were
actively engaged in public health nursing.
a USIIAA for:
Number
24
nursing advisors provided
Field of Preparation
Public Health Nursing
assistance
t Man Years
79
* 546 public health nurses-- 13 143 of which are employed by the
Nursing Section, MOH.
ran American Sanitary Bureau/ World Health Organization
(PASB/WHO) is sponsoring a longterm health project in 2 states in
the Amazon Valley and 9 states in the Northeast.3
e Assistance in the development of SESP's only field health
programs from 1942 to 1953 were: - Amazon Valley Health Project; -
Rio Dace Valley Health Project; - San Francisco Valley Health
project.
PASB/WHO started the Dourados project in Northeast Brazil in
1960, terminated in 1963, having established 5 health posts, 5
dispensaries, given92,099, immunizations.
PUBLIC REALTH NURSING PERFORMED:
SERVICES PUBLIC HEALTH PERFORMED:
NURSING SERVICES -
* It was thought that public health nursing, service in Brazil
as we know it did not exist; however, there were those who
practiced public health nursing according to Braziliancriteria and
curative needs.
a IIAA assisted-in the development of SESP's nursing services
by: - Establishing the Nursing Division of
SESP. An IIAA advisor was director; in 1951 a Brazilian Nurse
became Director, Nursing Division, SESP. 1
a The majority of nurses engaged in public health services were
with the state health departments and the National Tuberyulosis
Association in 1950.15
e Functions of Nursing Division: - develop in-service training
programs for graduate nurses, visitadoras,and auxil-iaries
hospitalaries.
- develop nursing services within Nursing Division.
a Others are found to be employed in the Nursing Section, MOH,
and the City Health Department of the large cities. L'
-
1942 I,TED STATES AGKNCY FOR INTERNATIONAL
ACTION TAKEN BY USAID 1942-1963 DEVELOMET NURSING IN BRAZIL
STATUS - 1963 ACTION TAKEN BY 18
OTHERS PUBLIC HEALTH RURSING SERVICES PERFORMED: (Continued)
PUBLIC HEALTH NURSING SERVICES PERFORMED: (Continued)
* In 1952, IIAA advisors assisted SESP nurses in a study of the
objectives and functions of the Nursing Division.
A. Objectives were: - promotion and Development of SESP
nursing services; - Promotion of nursing education.
a In 1953, IIAA advisors assisted.SESP nurses in developing
additional responsibilities: - creation of training section of the
Nursing
Division for preparation of public health nursing and hospital
auxiliary personnel;
- cooperation with non-SESP projects.
o The inclusion of public health nursing theory and field
experience in the basic nursing program was of great importance to
feature public health nursing and its plans for future
achievements.
The need for post-basic courses in public health nursing grew
out of the inadequate preparation of the graduate nurses and
difficulties encountered in carrying out such a program.
GUIDELINES PRACTICE:
FOR PUBLIC HEALTH NURSING -
GUIDELINES PRACTICE:
FOR PUBLIC HEALTH NURSING
* Unknown. * See "Federal Agencies, Plan."
Health
TRAINING INSTITUTIONS: TRAINING INSTITUTIONS: Professional
Nursing Schools: Professional Nursing Schools:
* 4 Schools of Nursing were approved a Nursing advisory services
were provided * 3 Schools of Nursing. by the Min stries of
Education and in Nursing Educations as follows: Health. 10,
Number Advisors Nan Years Months
I Nursing Service 2 5 Public Health 16 4 1
Nursing* 1 Pediatric Nursing 2 3 1 Psychiatric Nursing 1 8
*Not counted under Publie Health Nursing.
* SEEP nursing staff and USAID nursingadvisors assisted these
Schools of Nursingby: - planning and organizing schools; - serving
as Faculty embers; (Cont'd.)
-
UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT NURSING IN
BRAZIL STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 I STATUS -
1963 1 ACTION TAKEN BY OTHERS
19
TRAINING INSTITDTIONS: (Continued) Professional Nursing Schools:
(Continued) Cont'd. from page 4:
- providing on the job training for facultymembers;
- organizing hos tal wards into suitable areas for studint
learning;
- providing English classes for students and faculty;
- orjanizing Fublic health units into suitable areas for student
learning experience,
- training auxiliary nursing personnel who staffed the hospitals
and public health centers.
* SESPIIAA Servicio provided: - funds for building, remodeling
or the pur
chasing of nurses residence, classrooms,and health centers;
- basic nursing scholarships for 4 student nurses to study in
the United States and 89 in Brazil;
- basic nursing funds for salaries of Directors and Faculty;
- nursing and scientific literature for schools.
e Lesser assistance was given to 10 other schools of nursing by
SESP/IIAA, details not available.
* Participant Training Programs-United States: Number Field of
Preparation anfYes Mts
11 Public Health Nursing 11
9 Nursing Education 6 4 Nursing Supervision 8
and Administration
Practical Schools of Nursing:
e 1 Practical School of Nursing. * SESP nursing staff provided
assistance to 2 Practical Schools beginning in 1952.
A. Practical School in Aracaju, State of Sergipe; - SESP nurse
is Director; -2 SESP nurses are instructors - 20 students provided
with scholarships.
B. Practical School in Maceio, State of
- SEP nurses are instructors. 101
TRAINING INSTITUTIONS: (Continued) Professional Nursing Schools:
(Cont'd
W. K. Kellogg Foundation provided 10 scholarships to study basic
nursing in the United States.
Practical Schools of Nursinmt
* 43 Practical Schools of Nursing. 1il
-
UNITED STATES AGENCY FOR INTERNATIONAL DEVELOMENT NURSING IN
BRAZIL 20.
STATUS 1942 ACTION TAKEN BY USAID 1942-1963 1 STATUS' - 1963
ACTION TAKEN BY OTHERS
NATIONAL SCHOOLS OFFERING PREPARATION FOR GRADUATES THE
COUNTRY:
ADVANCED WITHIN
NATIONAL SCHOOLS OFFERING ADVANCED
PREPARATION FOR GRADUATES WITHIN THE COUNTRY:
* None. * 1947-1960: IIAA public health nursing advisors
provided advisory services to the Public Health Post Graduatq
Course, University of Sao Paulo by: 1
- selection of Brazilian nurses for postgraduate study in the
United States, for faculty positions in the program;
- assisting in strengthening the health centers to be used in
field practice;
- assisted in establishing the curriculum and setting up
courses;
- assisting to establish rural health centers for field
practice;
- assisted in establishing admission and academic standards.
* There are 7 training institutions providing eleven post-basic
programs for graduate nurses as follows: -
- 2- Public Health Nursing; - I - Nursing Education;
S- 1- Administration of Nursing Schools;
- 1 - Administration of Nursing Service;
- 5 - Midwifery.
W. K. Kellogg provided $4,155 to the University of Sao Paulo for
faculty and staff fellowships in the United States, 1964.
$34,777 to assist in developing post-graduate education in
nursing service administration.
$69,000 to improve nursing education and service by establishing
courses in public health
21and obstetrical nursing.
In-Service Training Program: In-Service Training Program:
* Unknown.
Number of graduates: - Unknown.
* 1943-1953: SESP and IIAA nurses organized and established a
varity of in-service training programs for: (Examples only)
* See "Action Taken column.
by USAID"
SESP Nurses: - 3-month course in orthopedic nursing-
51 nurses; - Refresher course in Public Health Nursing--100
nurses;
- Refresher course in Nutrition--30 nurses; - Refresher course
in communicable
disease--20 nurses; - Social Problems related to Nursing-
59 nurses:
Vistadoras Sanitaris (Public Health Auxiliaries): . 293
Vistadoras Sanitaris.
Auxiliarias Hospitalaris (Hospital Auxiliaries). - 605
Auiliarias Hospitalaris. 16/
-
21
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
NURSE-DIRECTORS OF SCHOOLS: NURSE-DIRECTORS OF SCHOOLS:
* Unknown. a 33 Nursing Schools have nursedirectors as indicated
by the 1965 Directory of Schools in Latin America.
REQUIREMENTS FOR SCHOOLS OP NURSING: REQUIREMETS FOR SCHOOLS OF
NURSING:
* Unknown. a Professional Nursing School-- FASB/WEO assisted
Latin completion of High School; American nurses in the
* Auxiliary Nursing School--completion of 5th
grade;forgrade;-in
preparation of "Guide Schools of Nursing
Latin America" in
* Length of - 3 years
Professional Program:(some are 4-year
1960. Brazilian nurses were on the Comittee.
University programs);
" Length of Auxiliary Programs: - not less than 9 months.
FASB/WO assisted Latin American Nurses in the preparation of a
"Guide
Supervision of Final Official Supervision of Final Official for
the Training of Examination: Examination: Nursing Auxiliaries
in
Latin Americas in * Unknown. a By individual schools. 1964.
Nursing Division, MOR, provided Guidelines for Schools.
STANDARDIZATION PROCEDIURES!I STANDARDIZATION PROCEDURES:
e Standardization of schools-- . StandardiAation of
Schools-curriculum guide: - Decree No. 27, 426. 12/-
curriculum guide: Decren No. 27. 426 of 1949 sets minimum
standards.
* National Examination: National Examinationa p - Decree No. 23,
774 (refers only -For Practical Schools only.
to Practical Nursing Schools).f
-
22 UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT NURSING IN
BRAZIL
STATUS - 1942' ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
CRITERIA FOR A GOOD SCHOOL: CRITERIA FOR A GOOD SCHOOL: -
* None. - Guide for Schools of Nursing in Latin America prepared
by the participants in the Seminar of Directors of Schools of
Nursing held in Paracas, Peru, November, 1960. 17
PROFESSIONAL NURSING ORGANIZATIONS: PROFESSIONAL NURSING
ORGANIZATIONS:
* Brazilian Nurses Association-- . During the entire existance
of SESP, * Associasco Brasileira Enfermeiras founded 1927--member
of Inter- United States nurses assisted in Diplomados. national
Council of Nurses 1929. building a strong foundation for the
nursing profession in Brazil by strengthening the National
Nursing Association. One advisor (during a five-year period)
assisted with the reorganization of the Association. 1020/
20 * Further assistance was provided in *Significant activities
undertaken: PASB/WHb provided techni
activities undertaken by the National Nursing - Annual Nursing
Congress; al assistance in con-Association: - Hosting 1oth
Quadrenial Congress dcting the Survey of - Annual Nursing Congress;
of the international Congress of Neds and Resources of - Hosting
the 10th Quadrenial Congress of the Nurses; ursing in Brazil.
International Congress of Nurses; - conducted a Survey of Needs
and ockefeller Foundation - Survey of Needs and Resources of
Nursing Resources of Nursing in Brazil; provided $55,000 to in
Brazil. - Preparation of nursing literature conduct the survey,
in the language of the country.
NURSING LITERATURE IN THE LANGUAGE NURSING LITERATURE IN THE
LANGUAGE OF THE COUNTRY: OF THE COUNTRY:
* Unknown. * USAID advisors assisted Brazilian nurses * Nursing
literature in Spanish andf PASH/WHO is the clearing in translations
of nursing texts, con- or Portuguese is being developed-- house for
articles in ference reports, articles, and papers. examples:
ArticlesGlossary
for the Boletin;of 7 ursing terms was
Spanish and Portuguese. - Boletin is supported
by PASEIWHO. developed; -
- Survery of of Nursing
Needs and Resource in Brazil, 1963,
Financed by Rockefeller Foundation wit a grant
prepared by the Brazilian Nure of $40,000.12W Association;
- Third Conference of Deans of Schools of Public Health
Reportof
- Various nursing texN ences on nsrsrvyg.
and refer
-
23 UNITED STATES AGENCY FOR ENTOA EV~lN IRT~lI RZTL
STATUS - 1942 ACTION TAKEN BY USAID 1942-1963 STATUS - 1963
ACTION TAKEN BY OTHERS-
NATIONAL EMPLOYMENT CATEGORY IN THE NATIONAL EMPLOYMENT CATEGORY
IN THE MINISTRY OF HEALTH: MINISTRY OF HEALTH:
e Unknown. . Category "nurse" is recognized by the Government
for employment purposes.
HOSPITALS: HOSPITALS:
* Unknown. * SESP nurse advisors established standard staffing
pattern for SESP Hospitals.
* 2,622 Hospitals (1959)--20 hospitals assisted by SESP. 1
- 233,303 beds. 20/
-
24UNITED STATES AGENCY FOR INTERNATIONAL DEVEIOPMENT NURSING IN
BRAZIL
REF ERE N C E S
1. WORLD HEALTH ORGANIZATION. Second Report on the World Health
Situation, 1957-1960, Geneva, 1963.
. First Report on the World Health Situation, 1954-1956, Geneva,
1959.
. Annual Report of the Director, Pan American Sanitary Bureau,
Regional Office of the World Health Organization, Washington, D.C.,
1953.
. World Director of Vost-Basic and Post-Graduate Schools of
Nursing, Geneva, 1965.
5. . Guide for the Training of Nursing Auxiliaries in Latin
America, Pan American Health Organization, pan American Sanitary
Bureau, Regional Office of the World Health Organization,
Washington, D. C., 1964.
. Guide for Schools of Nursing in Latin America, pan American
Health Organization, Pan American Sanitary Bureau, Regional Office
of the World Health Organization, Washington, D.C., 1960.
7. . Annual Report of the Director, Pan American Sanitary
Bureau, Regional Office of the World Health Organization,
Washington, D.C., 1954
. Annual Report of the Director,Pan American Sanitary Bureau,
Regional Office of the World Health Organization, Washington, D.
C., 1962.
9. . Annual Report of the Director, Pan American Sanitary
Bureau, Regional Office of the World Health Organization,
Washington, D.C., 1951.
10. INSTITUTE OF. INTER-AMERICAN AFFAIRS. Report on Nursing in
the Brazil-United States Cooperative public Health Service,
1942-1953, Clara Curtis, Rio de Janeiro, Brazil.
r 11. . Report on Nursing in the Brazil-
United States Cooperative Public Health Service by Clara Curtis,
Rio de Janeiro, Brazil, 1953.
12. UNITED STATES INTERNATIONAL COOPERATION ADMINISTRATION.
Terminal Report of Margaret Albold, Public Health Nursing
Consultant, March 3, 1959.
13. BRAZILIAN NURSES ASSOCIATION. Survey of Needs and Resources
of Nursing in Brazil, Rio de Janeiro, Brazil, 1963.
14. SERVICIO ESPECIAL DE SALUDE PUBLICA. Selected Statistics for
Public Health Personnel of S.E.S.P., Brazil, April, 1948.
15. MINISTERIO DA EDUCOCAO E * CULTURE. Brief Review of Nursing
in Brazil, Glete De Alcontara, Former President of Brazilian Nurses
Association.
16. UNITED STATES OPERATIONS MISSION TO BRAZIL. Report on
Nursing in the Brazil-United States Cooperative Public Health
Service 1942-1953, Clara Curtis, Nursing Advisor, Rio de Janeiro,
Brazil Appendix 9 and 10.
17. PAN AMERICAN SANITARY BUREAU. Report on School of Nursing in
Latin America, prepared by participants in the Seminar of Directors
of Schools of Nursing Paracas, Peru, Pan American Sanitary Bureau,
Regional Office of the World Health Organization, Washington, D.
C.
-
UNITED STATES AGENCY FOR INIERNATIONAL DEVELOPMENT NURSING IN
BRAZII, 25
REFERENCES
18. PAN AMERICAN SANITARY BUREAU. Regional Office of the World
Health Organization, Reported from unpublished questionnaire 1966,
Washington, D. C. 1966.
19. . Regional Office of the Wbrld Health Organization, Health
Conditions in the Americas, 1961-1962, Publication No. 104, August
1964.
20. UNITED STATES INTERNATIONAL COOPERATION ADMINISTRATION.
Terminal Report of Beatrice I. Lehnington, Hospital Nursing
Advisor, TOICA-A-1279, Rio de Janeiro, Brazil, March 11, 1959.
21. W. K. KELLOGG FOUNDATION. Annual Report 1964, Battle Creek,
Michigan.
22. UNITED STATES OPERATIONS MISSION TO BRAZIL. Report on
Nursing in SESP, Clara Curtis, Nursing Consultant, Brazil, July 3,
1953.
23. UNITED STATES AGENCY FOR INTERNATIONAL DEVELPMENT. End of
Tour Report, Marjorie W. Spaulding, National Advisory Nurse, Rio de
Janeiro, Barzil, June 12, 1963.
-
26 NURSING ADVISDRS--BRAzIL- 1942-1963
Louise C. Kieninger - - - - - - --- - - - -- - - 1942-1943
-Lottle Chaiken Plant Agnes Chagas - - -
--
- - -- -
- -- -
--
- -- -
-- - -- 19C3-1945
---1943-1944
Clara Cuti - t - * - - - - - - - - - - - -943-1953 Blizabeth
Read - - - - - - - - - - - - - - - 1943-1945 Carrie Reno Teixeira-
- - - - - - - - - - - - 1943-1953 -Anne S. Wells - - - - - --.- - -
- - --- - 1943-1946 Tessie Williams - - - - *- - - - - - -- - - -
1943-1953 Delores M. Kese - - - - - - - - - - - - - - - 1943-1944
Gertrude M. Eodgenan - - - - - - - - - - 1943-1945 Verna Roster - -
- - - - - - - - - - - - - - - 1943-1944 Ella Hasenjasger Rosita
Petegnat
--
- --
-- - -
- - - - - - - - 1944-1951 - - - - - - - ** -1944-1946'
-
Ruth J. Smith - - - - - - - - - - - - - - * - - 1944-1945
Elizabeth Waterbury - - - - - - - - - - - 1944-1946 Florence J.
Murphy - - - - - - - ---- - - - - 1946-1946 Appolonia Olson Adam. -
- - - - -*- - - - -1946-1946 Mliei M. Quass - - - - - - - - - - - -
- --- 1946-1946 Celestine Weanofeke - - - - - - - - - - - - -
1946-1949 Irene Weed - - - - - - - - - - - - - - - - - 1946-1947
Catherine Kain - - - - - - - - - - - - - - 1947-1948
-nernie-Herreid . - - - - - - - - - - - - - -- 1947-1948 Bunice
Rerreid - - - - - - - -' - - ! 1947-1948 Nabel Johnson - - - - - -
- - - - - - - - - - 1947-1955 Dorothy Doyle Watts - - - - - - - - -
- - 1949-1950 -Gladys Lee - - - - - - - - - - - - - - - - 1949-1951
. -Su. Nickerson--- - - - - - - - *-- - - 1949-1950 Beatrice
Lennington - - - - - - - - - - - - 1952-1959 Frances.Yrazier- ----
- - - - - - - - - - - 1953-1955 Anne Matter - - - - - - - 1953-1954
Verna Fraser - - - - - - - - - - - - - - - - 1954-1956 Margaret
Albold - - - - - - - - - - - - - - - 1944-1961 Lucy Goedert - - - -
- - - -- --- 1955-1957 Alcea-Lag!ay - - - - - - - - - - - -
1956-1958
ala Boneas- -r- - - - - - - - - - - - 1957-1959
TOTAL MAN-TARS OF NURSING ASSISTANCE TO THE cDsITRY
35 90
-
27
BRITISH GUIANA
In 1962, the AID Mission in British Guiana and the Ministry to
the field of nursing. 2. System of Instruction It has been of
Labor, Health and Housing,agreed to a project which would suggested
that the objective sought is not to change the present upgrade
nursing resources to international standards. The educational
system basically, but t6 improve it. 3. Tutors: The project was
initiated in FY 1963 by the assignment of a 5 fully qualified
tutors in the nursing schools be fully utilized nurse educator to
the staff of USAID who arrived in 1962. and the relationship of the
tutor between the classroom and the
hospital ward modified to permit a closer tie-in between the The
survey of nursing resources was done and the report classroom and
the wards in the hospitals, written in February, 1963. Summary of
the findings and conclusions are: D. D. Examinations - Serious
consideration to the problem of
examinations presently given and their usefulness in A.
Resources - Approximately 1,250 graduate nurses determining what
better purposes they may serve, re.
registered under the Nurses and Midwives Act of eligibility to
practice nursing as a graduate nurse. 1953. No estimate of the
number living in the country. It is reported that 615 nurses were
em- E. Status of Profession - 1. Profession lacks esteem in the
ployed by the Government hospitals and 75 in public eyes of the
public. 2. Remove the Ordinance which prehealth. Approximately 948
midwives are registered vents married women from being employed in
government. under the same Act of 1953. 3. Staff functions in
nursing are frequently those of maids,
supervisors of maids, and personnel in nonnursing departments.
Four sebools of nursing with 200 students enrolled. 4. Lagislation
for the establishment and employment of a It is believed, however,
that none of these nurses "practical" nurse. who are graduating
(90-1962) are fully qualified to perform nursing as it is generally
recognized F. - iHealth Nurqig - Well organized, unpretentious, but
internationally. practical group. Value is recognized and is
striving to
contribute to the needs of the people. B. Needs - Best estimate
would be approximately one
nurse per 300 population. Based on a population of G.
Instruction and Status of Students - 1, No supervised slightly less
than 600,000, this estimate would practice. 2. Major instruction
given by tutors in the require approximately 2,000 nurses to
adequately first three months of training. Remainder of the
teaching meet the needs of the country. is done by doctors
throughout the three years.
C. Education Standards - 1. Entrance Requirements: H. Midwifery
Courses - 1. Urban midwives. 2. Rural midwives. Due to the lack of
academic training in the student applicant the schools should
require a 1. sick Nurse Diagens rse - Prepares male nurses for the
general certificate of education in at least 4 job of dispensing
medicine and performing minor medical subjects, including English
and Arithmetic to treatment in the smaller health centers. attract
higher grade applicants. One solution would be to upgrade nursing
to the professional The nurse advisor recommended two major
developments; level, thereby attracting higher calibre
personnel
1. Establish a department o nursing in the MDH and appoint a
Director to head it up. The Director would be given the authority
and responsibility for a necessary and needed change in
nursing.
-
28
BRITISH GUIANA (Continued)
2. USAID assign a Chief Nurse Advisor to the Office of the
Director of Nursing, MOH, and would assist in every possible way in
implementing the recomendations.
Educational as follows:
Number
Training Program in the United States provided
Field of Preparation Man[YearsltMonths
The Aid advisor returned to the United States in 1964, but no
literature is available to determine whether the MOR acted on the
recomendation of implemented the suggestions. AID Mission did not
continue the project beyond FY 1964.
Public Health Nursing 9
-
29
NURSING ADVISORS--BRITIS GMANA-1962-1964
Jeanette Welsech - - - - - - - - -1962-1964
TOTAL HAN-YEARS OF NURSING TOTAL NURSES ASSISTANCE TO THE
COUNTRY
I 2
-
30 .UNITED STATES AGENCY FOR INTERNATIONAL DEVELCPMENT NURSING
IN CHILE
STATUS - 1943 ACTION TAKEN BY USAID 1943-1963 STATUS - 1963
ACTION TAKEN BY OTHERS
POPULATION: 5,023,539 POPULATION: .7,339,546
NUMBER OF NURSES: io5 7 NUMBER OF NURSES: 1,656 -L/
NUMBER OF MIDWIVES:
AUXILIARIES AND 5,626
NUMBER OF AUXILIARIES MIDWIVES:
AND 9,746 U
TOTAL NURSING PERSONNEL: 6,641 TOTAL NURSING PERSONNEL: 11,402
1
NURSING PERSONNEL POPULATION:.
PER 130:100,000
NURSING PERSONNEL POPULATION:
PER 150:100,000
COUNTRY AREA: 741,767 square kilometers.
MINISTRY OF HEALTH: MINISTRY OF HEALTH:
* Ministry of Public Health, Welfare and Social Security is the
title of the Ministry of Health.
" National Public Health Service is a division of the MPHWS.
First Public Health Agency--Consejo--1892.
o Organizational structure of the Ministry of Health (MOH)
seemed to be well planned. Director Gen-eral is the chief officer
and has a Ministerial status,
e The U.S. Government, through the In-stitute of Inter-American
Affairs (IIAA), in cooperation with the Ministry of Public Health,
Welfare, and Social Security of Chile established and organized the
Inter-American Cooperative Public Health Service (Servicio) and its
health plan for the country at the National level. The Agreement
was signed May 12, 1943.
.
.
Ministry of Health called National Health Sqrvices--established
in 1952. fl
To be reorganized in 1960. However, reorganization was
interrupted by disastrous earthquake. A single technical department
was established to supervise all health administration at the
National level. Hospitals are centers of regional administration
for all health. 16/
Overall Health Plan: Overall Health Plan:
* 1927: Dr. Long of Lima, Peru, helped to instigate the Public
Health Service in Chile and was the author of the Long Code," first
sanitaryofof he"Logod," irt aniar code.
o 1924: First mass medical care; 1936: *First maternal and child
health
care; 1936: First Public Health Center,
CentSvde Salud. 12/
. USIIAA assisted the National Public Health Service in
providing for the needs of the country such as: -water supplies; -
Sewerage disposal;
-Hospitals and health centers; Public Health facilities and
trained public health personnel.
a There are 15 health zoes in Chile each with a Chief Medical
Officer. Each zone has oe regional hospital
salerhospitals.The Health Centers are the executive units, at
the Heart of the organiztion and they are in charge of all medicai
care and public health
-
91 STATUS 1943 ACTION TAK BY USAID 1943-1963 STATUS - 1963 ACTUD
TARB T OHER
MINISTRY OF HEALTH: (Continued) ,MINISTRY OF HEALTH:
(Continued)
Health Services Provided: Health Services Provided:
* Practiced curative medicine with e Servicio in Ju 1943
constructed, a Medical care; hospitalization of all conditions.
equipped four health centers in Epidemiology; No preventive health
care practiced to any degree countrywide.
Santiago, Valparaiso, Antofogasta and Temuco at a cost of
$650,000.
Maternal and Child Health; Laboratory Service; Pharmaceutical
Services;
e Also constructed and equipped the following:
Nutrition; Malaria Control. 13/
- Protectora de Ia Infancia; - National Institute of Radium; -
The Bacteriological Institute; - The Virus Building; - School of
Hygiene;
Cost of the above totaled $324,641.
NURSES IN THE MINISTRY OF HEALTH: NURSES IN THE MINISTRY OF
HEALTH:
* No Chief Nurse or Nursing Division in the Ministry of
Health.
a There is a in the MOL
Sub-Department of Nursing
o Staff of the Nursing Department includes: - Chief Nurse; -
Assistant Chief Nurse; - 3 Nursing Consultants.
* Nurses employed by the National Health Pan American Sanitary
Service are under the Sub-Department Bureau/World Health of
Nursing, MO. 12 Organisation (PASB/WHO)
provided assistance in 1960 of a Nurse Educator and a short-term
consultant to help with National plan for Nursing 1960-1969. -
-
UNTTED STATES AGENCY POR INTERNATIONAL DEVEIOPMET NORSING IN
CHILE 32 STATUS - 1943 ACTION TAKEN BY USAID 1943-1963 STATUS -
1963 ACTION TAKEN BY OTHERS
ADVANCED EDUCAIONAL TRAINING FOR ADVANCED EDUCATIONAL TRAINING
FOR LEADERSHIP GROUP! LEADERSHIP GROUP:
* Unknown. * IIAA Chief Nurse arranged for two months .
Post-basic program in the adminis- Prior to 1947, 27 nurses course
in public health nursing and tration of nursing service, have done
graduate study techniques at Cerro Barron Health Center. in the US
and Canada. Between 1944-1946, 18 graduate nurses Two-year progran
in Public Health 23 fellowships given by completed course and
helped to staff Nursing. Rockefeller and Kellogg health centers.
Set up suitablq urban Foundations, American practice fields for
students. . Red Cross, PASB, Johns
Hopkins, Readers Digest, University of Chile and others.
1947-48, five nurses supported by Rockefeller, Kellogg Foundations
qnd American Red Cross.-'
PUBLIC HEALTH DEPARTMENT: PUBLIC HEALTH DEPARTMENT:
a See Ministry of Health. * See Ministry of Health.
PUBLIC HEALTH NURSES IN THE PUBLIC HEALTH NURSES IN THE
COUNTRY:COUNTRY:
o 370 Public Health Nurses from * IIAA provided nurse advises to
give * In 1957 there were reported to be 1905 to 1942 (estimated),
assistance in: 1,069 public health nurses.
Number Advisors Man Years
2 Public Health Advisors 6
-
UNITED STATES FOR DEVELO39ENT IN CHILE ANAGENCY
INTERNATIONAL6STTRSINGSTATUS - 1943 ACTION TAKEN BY USAID 1943-1963
1963 TAKEN BY OTHERSjSTATUS - (ACTION 33
NURSES PREPARED IN ACADEMIC PUBLIC NURSES PREPARED IN ACADEMIC
PUBLIC HEALTH PROGRAMS: HEALTH PROGRAMS:
* 1927-1943: 213 nurses prepared in public a USIIAA
Assistance--Participant Trainees: * 1957: A total of approximately
500 PASBIWHO Fellowships: health nursing. Third country training
Chilean nurses have been taned - 1950--2 in Nursing in public
health nursing at the Uni- Number Field of Preparation Man Years in
public health nursing. - Education; 1 versity of Chile. 5 - 1951--1
in Public Healt
Public Health Nursing 2 28/ Nursing, United States-t/ - 1952--2
in Comunicable
* Servicio public health nurse advisors gave Disease Nursing,
United training program on making home visits. States, 2/
- 1955--t to United States o Servicio Health Center Qunta Normal
was used (Chief Nurse); L/
for field experience in Public Health Nurs- - 1959-- 1 to United
ing. The Rockefeller Foundation assisted in States. L the program's
operation by furnishing space, equipment, teaching materials,
reference * First courses in Public manuals of procedures and
techniques. The Health Nursing organized University of Chile School
of Nursing by Hiss Sarah Adams in teaches the curriculum. From
1944-1949, 1925 at the University 200 students have had field
experience. of Chile. 1/
170 Chilean nurses 16 Argentinian 2 Bolivia 4 Columbia 1 Ecuador
2 Mexico 3 Peru. l/
PUBLIC HEALTH SERVICES PERFORMED: PUBLIC HEALTH SERVICES
PERFORMED:
e Public Health nurses participated in . Preventive Care
Programs; Finnish Nurse Consultant the following activities:
ECPrograms; cama with BCC Campaign - Well baby clinics; Educational
Programs in Nutrition; Team. - Prenatal and obstetrical clinics;
Mothers Club Activities; - Internal Medicine; Home Visiting; -
Epidemiology social wg k; Clinic Administration; - Home nursing
visits. Mothers Class Demonstrations;
Health Teaching. I'
-
34 UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMIE1T HNIRSING
IN CHILE STATUS - 1943
GUIDELINES FOR PUBLIC HEALTH NURSING PRACTICE:
o Unknown.
TRAINING INSTITUTIONS:
Professional Nursing Schools:
* A schools of nursing--basic education controlled by University
of Chile since 1923--3-year course
7/considered professional since 1929.
ACTION TAKEN BY USAID 1943-1963
o Servicio provided funds for the training
of 4 students in 1945 and 9 in 1946 at the National School of
Nursing. Training given to provide public health nurses for the
Health Centers. A/
* University of Chile recognized 4 o USIIAA Regional Nurse
Consultant gave nurs-Schools of Nursing: ing education advise upon
request. - University School of Nursing;
o Requests were made to the IIAA Regional- School in Santiago;
Nursing Consultant for a full-time nursing- School in Valparaiso;
education advisor but the request was not - School in Concepcion.,
honored. 10/
* No degree program existed
