Aries N
Department of Health Care Administration, Baruch College, Mt. Sinai School of Medicine, City University of New York, NY 10010.
Am J Public Health. 1987 Nov;77(11):1465-71. doi: 10.2105/ajph.77.11.1465.
This paper analyzes the evolution of the federal family planning program from 1960 to 1980. Political pressure to offer family planning raised the question how best to organize services. Long-standing providers preferred a categorical approach in order to maintain a diverse political coalition for an historically invisible service. In addition, categorical funding meant financial support for non-traditional providers. A compelling argument was also made for service integration. Given an expanded definition of health and the medicalization of contraceptive technology, the health delivery system presented itself as the appropriate service provider. Neither group prevailed. By 1980, federally supported family planning services were provided in autonomous clinics but also were integrated into existing maternal and child health programs. The debate continues but, under the Reagan Administration, terms and motivations differ from those of the past.
本文分析了1960年至1980年联邦计划生育项目的演变。提供计划生育服务的政治压力引发了如何最佳组织服务的问题。长期存在的服务提供者倾向于采用分类方法，以便为一项历史上不显眼的服务维持一个多样化的政治联盟。此外，分类资金意味着对非传统服务提供者的财政支持。也有人提出了令人信服的服务整合论据。鉴于健康定义的扩大和避孕技术的医学化，卫生服务提供系统成为了合适的服务提供者。双方都未占上风。到1980年，联邦支持的计划生育服务既在独立诊所提供，也被纳入现有的母婴健康项目。这场辩论仍在继续，但在里根政府时期，其条件和动机与过去有所不同。
