Abstract Health development in developing countries invariably involve the improvement of existing health structures, the development of new strategies to cope with new demands in situations of scarce resources, and the implementation of programmes which could reach the majority of the population. Most of the population in developing countries is rural. 1n some cases, people are scattered and are difficult to reach. This is the situation in Kenya. The country's population is about 90% rural. Rural health programmes designed to provide services for that proportion of the population include a hierarchical system beginning with mobile clinics, dispensaries, sub-health centres and health centres. This paper discusses the system available to the rural population, how it is implemented and goes on to show that the Kenyan health development programme stresses the improvement of hospitals in urban areas rather than the improvement of rural health services. The rhetoric in health planning is not consistent with actual health programmes.
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