Health care in developing countries

Abstract

Health care at the most peripheral level consists of simple and effective measures founded on feasible scientific technology and on traditional practices, utilizing resources and manpower but integrated into the larger health network. A wide range of possibilities exist within this definition. The World Health Organization, the International Bank for Reconstruction and Development, the United Nations International Children's Emergency Fund and other groups are actively supporting country health care programmes. Applied research to determine factors which influence population coverage and health care utilization has been carried out, as have surveys to determine need, and the results of these investigations are currently being applied on a limited scale in various country settings.

Some developing countries have developed health care programmes at the most peripheral level to meet the health and development needs of the deprived populations. Each experience has followed a particular approach. China uses mass education programmes and “barefoot doctors” to deliver primary health services. Tanzania has instituted massive rural population re-location efforts to facilitate delivering health care and other government-sponsored development service. By subordinating health care per se to the related fields of agriculture, water supply and housing, projects in India have encouraged village acceptance of primary health care. Venezuela and Iran have excellent referral systems working up from local levels to highly specialized hospitals. Cuba, through political reform, has extended coverage to nearly all of its population. In Niger voluntary workers help keep costs at a minimum. In Sudan, a National Health Programme has been adopted.

None of these approaches have reported enough data to be completely evaluated, but each has attained some degree of success in serving deprived populations.