Health Care Patterns and Planning in Developing Countries

By Rais Akhtar | Go to book overview

exchange will not help assure active peasant participation, particularly after fees have been collected.

The concept of primary health care is nevertheless, revolutionary in the sense that it comes close to the ideal situation discussed at the beginning of this chapter. The primary health care approach in Zambia is approaching the situation diagrammatically shown in Figure 11.3. Limited resources are being provided to support a more preventive programme to a larger part of the population with, increasingly, a more labour-intensive (and less import-intensive) delivery system. The departure from the previous paradigm has thus far been slow because of certain inherent problems. However, stress on the use of community health workers and other medical auxiliary staff, as well as on community participation by public works construction techniques and other publicly supported programmes, are clear signs that a definite new pattern is being born in the country (albeit with severe "birth pangs"). With it has come a new vocabulary and new concepts such as catchment areas, accessibility, and community participation. Indeed, it is now also recognized that people, not diseases, are to be treated.


NOTES
1.
Beck ( 1970, p. 200) has stated that in 1903 medical administrators were instructed, first, to preserve the health of the European communities; second, to keep African and Asian labour in good working condition; and third, to prevent the spread of epidemics. As Doyal and Pennel ( 1976, p. 162) have correctly noted, such a policy entailed selective minimal health provisions for miners, plantation workers and railway builders--all crucial in an extractive economy. The health problems of the masses (apart from the crucial workers) were threatened by contagion.
2.
Namilikwa and Wilkinson ( 1968, p. 13) have reported that from the beginning of their activity the mining companies in Zambia have provided health services for their employees. They provide six hospitals and some urban clinics, with a total of 1,894 beds. They add that these services cater for the settled population employed by the mining companies. These hospitals (at Chililabombwe, Chibuluma, Luanshya, Mufulira, Chingola and Nkana [Kitwe]) are described as being "of a very high standard and are well- staffed and obviously do excellent work" (p. 49).
3.
Present coverage is expressed as a proportion, that is, the rural population within a 12 kilometre radius as the crow flies (15 to 20 km in reality) to the total rural population.

REFERENCES

Beck A. ( 1970) A History of British Medical Administration of East Africa 1900-1950. Cambridge, Mass.: Harvard University Press.

Benyoussef A. ( 1977) "Monitoring and Servicing National Health: Health Service Delivery in Developing Countries." International Social Science Journal, Vol. 29, No. 3, pp. 397-418.

Doyal L., and I. Pennell. ( 1976) "Pox Brittanica: Health, Medicine and Underdevelopment." Race and Class, Vol. 53, pp. 155-172.

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