Some methodologic problems in health practice research and health planning.

Abstract

During the past 15 years health planning has received a great deal of attention, and a large number of conferences, seminars, and papers have been devoted to this fascinating subject. However, because of a lack of guidebooks based on practical experience, many health agencies, especially those in developing countries, are afraid to embark upon sophisticated and costly procedures. Instead, they continue to use the “rule of thumb” in deciding on easy solutions in order to please local authorities. Health services have been compared to a tangled skein. The present paper suggests a practical approach to begin to disentangle the situation. Total health programs could be divided into three main parts: (1) environmental control and community protection, (2) personal preventive services, and (3) curative services, including rehabilitation. Each of these three main components should be defined and clear borders between them should be delineated because the methods of planning differ in each case. Leaving aside the first sector because it is in fact the responsibility of many government agencies, methods of assessing and planning personal preventive services are studied separately from those which could be applied to curative services. The distinction between these two last sectors is that between needs and demands. Warnings are given against easy oversimplification and ignoring of methodologic problems which could result in failure of the best theoretical health plan. Finally, health planning is within the reach of any health agency, even those in developing countries.