Medical anthropology and international health planning

International health planners have been slow to recognize that barriers slowing down the acceptance of modern medicine in traditional societies are just as much inherent in bureaucratic premises and operations as in the sociocultural forms of the recipient peoples. Beginning a generation ago anthropologists suggested an “adversary model” that posited a contest between modern and traditional medicine based largely on cultural dissonance, to explain resistances to change. Today it appears that quality, cost, and convenience of modern medicine rather than cultural incompatibility are the primary determinants of its acceptance. Medical role perceptions and the social costs of changes and reorganizations in health organizations are noted as problems in designing the most appropriate health services for developing countries. Possible roles for traditional healers in helping provide primary health care are discussed. Except for the use of indegenous midwives and perhaps mental illness specialists, it is argued, this approach will enjoy little success. In addition to doubts stemming from differing ideas of traditional and modern curers about etiologies and treatment, the proposal is based on an erroneous premise: that traditional healers will continue to be produced at the same rate as in the past. Contemporary evidence suggests their numbers will drop to a point where they will not constitute an adequate manpower reservoir, even should they be deemed accaptable on other grounds.