Alternative approaches to meeting basic health needs in developing countries. A joint UNICEF/ WHO study.

Abstract

Based on the failure of conventional health services and approaches to make any appreciable impact on the health problems of developing populations this study examined successful or promising systems of delivery of primary health care to identify the key factors in their success and the effect of some of these factors in the development of primary health care within various political economic and administrative frameworks. In the selection of new approaches for detailed study emphasis was placed on actual programs that are potentially applicable in different sociopolitical settings and on programs explicitly recognizing the influence of other social and economic sectors such as agriculture and education on health. Information was gathered from a wide range of sources; including members meeting reports and publications of international organizations and agencies gathered country representatives and field staff. The 1st section world poverty and health focuses on the underprivileged the glaring contrasts in health and the obstacles to be overcome--problems of broad choices and approaches resources general structure of health services and technical weasknesses. The main purpose of the case studies described in the 2nd part was to single out describe and discuss their most interesting characteristics. The cases comprised 2 major categories: programs adopted nationally in China Cuba Tanzania and to a certain extent Venezuela and schemes covering limited areas in Bangladesh India Niger and Yugoslavia. Successful national programs are characterized by a strong political will that has transformed a practicable methodology into a national endeavor. In all countries where this has happened health has been given a high priority in the governments general development program. Enterprise and leadership are also found in the 2nd group of more limited schemes. Valuable lessons both technical and operational can be derived from this type of effort. In all cases the leading role of a dedicated individual can be clearly identified. There is also evidence that community leaders and organizations have given considerable support to these projects. External aid has played a part and apparently been well used. Every effort should be made to determine the driving forces behind promising progams and help harness them to national plans.

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