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.
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.