Trends in primary health care.

Abstract

There are many problems related to the planning and delivery of primary health care services. Shortage of appropriately trained health personnel is a principal obstacle to delivery of primary health care services. Expanding the training of traditional health workers has failed to solve the service delivery problem. Health services need to be provided according to a progressive system of increasing expertise and skills from front-line care to base hospital care. A countrys stage of socioeconomic development will dictate the overall structure of a health care delivery team and will determine the standards that can be afforded at the primary health care level. The guiding factor in health personnel planning and recruitment should be what the area can train and sustain and not the population/personnel ratios. The 3 person team covering maternal and child health/family planning medical care and communicable diseases/environmental sanitation offers the optimum for a balanced integrated curative-preventive-promotive primary health care delivery system. The major block to expanding the number of trained auxiliary health care workers is a totally inadequate supply of informed knowledgeable and trained instructors. A series of coordinated actions is needed to overcome this block. In developing a curriculum for training health auxiliaries an interdisciplinary systems-analysis approach should be used. The concept of primary health care should be integrated into other sectors of national development. Another obstacle to the expansion of primary health care is a deficiency in field supervision and management.