A workable plan for improving health care in developing nations.

Abstract

A community health programme funded by several European donor agencies was implemented in the island of Koje Do off the south coast of Korea in 1969. Trained village health aides introduced in their assigned villages the concepts of health education, immunization, prenatal and well baby clinics. They also provided very simple treatment including local antibiotics, iron and vitamins, and treatment of parasites. The impact of this type of programme on the health status of the community is difficult to assess but anecdotal evidence suggest that some progress was being made. After 1974, there were no reported cases of polio and tetanus of the newborn, both conditions being highly prevalent in Korea. By 1977, there was a decline in reported cases of tuberculosis and typhoid fever. The essential features of the project included: 1) employment of local people as far as possible; 2) emphasis on major health care needs of the area (eg, family planning; maternal health; nutrition; immunization; intestinal diseases; tuberculosis); 3) use of locally trained paramedical workers; 4) emphasis on reaching the individual at the village level; and 5) emphasis on referral from lower to higher levels of medical care.