“No More Surprising Than a Broken Pitcher”? Maternal and Child Health in the Early Years of the Pan American Sanitary Bureau
Bibliographic record
Abstract
The priorities and activities of international health organizations have historically been determined at the metropolitan level or through a confluence of central and local interests. The case of maternal and child health and the Pan American Sanitary Bureau during the first half of the 20th century demonstrates a different phenomenon. Rather than sparking interest and actions in maternal and child health in Latin America, the PASB ignored this area even though the agency was repeatedly urged by numerous countries in the region over several decades to provide support. This article begins with an examination of the emergence of maternal and child health circa 1900 in Europe, North America, and Latin America, identifying political, demographic, ideological, economic, and cultural commonalities and differences in these regions. We then turn to the PASB's early history and modus operandi, the pressure exerted by Latin American countries upon the PASB to pay attention to maternal and child health, and the Bureau's unwillingness to work in this area. Next we explore concomitant developments in maternal and child health and eugenics within Latin America in the 1920s and 1930s and the PASB's first steps in this area. Finally we discuss the conflict over the PASB's role in maternal and child health on several dimensions: as a manifestation of differing cultural priorities in the U.S. and Latin America; as a question of struggle for organizational power within the PASB; and as part of a richer understanding of the diffusion of early 20th-century public health and medical practices.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.021 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".