1. Higher – Development and Health
Primary Health Care

2. 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

3. Crosshouse Maternity Hospital

4. St Luke’s Hospital, Mombasa Kenya

5. 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

6. Rural China

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

8. 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

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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. Primary Health care centre

18. Primary Health Care – first aid kits

19. 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

20. 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

21. 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

24. 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