Higher – Development and Health Primary Health Care

The Provision of Primary Health Care LEDC’s are unable to afford the same level of health care found in the MEDC’s In an effort to improve the health of their citizens they have instead adopted a number of strategies classified as Primary Health Care An example of an early attempt to provide basic health care to large numbers of rural dwellers was set up in China in the 1960’s

Crosshouse Maternity Hospital

St Luke’s Hospital, Mombasa Kenya

cont The communist government was faced with a countryside which had virtually no access to health care Most villages lacked medical facilities and the nearest health centres cold be up to three days walk away Even if they could be reached, patients would find that they were poorly equipped and run by inadequately trained staff

Rural China

A rural hospital in 1960’s China – growing their own medicines

Barefoot Doctors To deal with this situation large numbers of local people were trained as medical auxiliaries called barefoot doctors They were given basic medical training which allowed the to treat straightforward illnesses and to refer more serious cases on to better equipped hospitals The typical medical auxiliary was a part time health worker

Barefoot Doctors – bringing health education and clean water to rural communities in India

Cont… The rest of the time they supported themselves in jobs such as farming The cost of running the medical service was met by the community and a combination of Western and traditional Chinese medical practices were used

Cont… In the early years the system was very successful at making inroads into the poor state of health in the countryside In recent years however the service has faced considerable pressures Despite the numbers trained it proved impossible to provide enough health care workers to satisfy the needs of rural communities

Cont… The introduction of private practice has not been to the benefit of large numbers of people The countryside is generally too poor to attract health workers who prefer to settle in the wealthier suburban areas Many rural communities are suffering from a lack of effective, affordable health care Unless a solution can be found to these problems the situation is likely to deteriorate

Cont… In addition, many were unable to continue paying for the training of auxiliaries and the upkeep of the health centres, so the system began to break down To try to deal with this, the Chinese government started to encourage medical auxiliaries, traditional doctors and hospital physicians to set up in private practice

Cont… Despite its lack of success, the pattern has been adopted by many countries in the developing world as they struggle to improve the health of those living in rural areas Difficulties – burdened with debt repayments and forced to make structural readjustments by the World Bank, many countries were unable to fund their health services

Tanzania In Tanzania, for example, medical treatment is no longer free – the ordinary citizen cannot afford to pay for the treatments In other areas such as Mozambique, civil war and natural disasters destroyed what had been a highly effective health provision many schemes however, still exist often funded by charities such as Christian Aid

Charities Charities tend to work with local organisations which are aware of local needs In India, Christian Aid works with local groups to train health volunteers and equip them with basic medical kits which are simple and cheap to provide and re-equip As the health volunteers are local people they are known and trusted by the communities which they serve

Primary Health care centre

Primary Health Care – first aid kits

Cont… An integral part of this partnership is an emphasis on health education The method is still an extremely cost effective method of reaching large numbers of people in the countryside allowing them to build a better future for themselves and their children

Appropriate Technology The other main emphasis is to concentrate on low cost, low technological solutions which encourage self help and cut reliance on the often expensive foreign medicines Attempts are being made to identify medicines which can be produced locally – often based on traditional practices which have proved effective in the past

Cont… An example is the use of Oral Rehydration Therapy (ORT – a solution of water, sugar and salt) to deal with the dehydration resulting from acute diarrhoea – one of the major causes of infant mortality in the developing world

Cont… The establishment of clinics to provide advice on nutrition, family planning and health education although more expensive will bring benefits in the long term as will large scale child immunisation programmes – needs foreign funding to be effective All these measures including foreign intervention are needed if inroads are to be made into the poor levels of health provision throughout the developing world