Managing Primary Health Care
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World Bank Discussion Paper No. 276.
A demographic and epidemiological transition is underway in most developing countries--only a few diseases once caused the majority of deaths, but the disease pattern is now more varied, requiring at least 15 different health interventions at the primary level. This paper examines the way in which the pattern of disease is changing in developing countries and the implications this has for the design and management of primary health care (PHC) programs.
The paper develops a conceptual framework for analyzing an environment of dynamic change. The author then applies that framework first to the management of primary health care programs provided by governments and then to the role of the nongovernmental sector in primary care. He draws broad conclusions about how the design of PHC programs should evolve to meet the changing needs of their clients. If the general approach adopted proves useful, the conceptual framework would next be applied to a series of specific country cases to test its validity and refine it and to adapt the general conclusions to local cultural, administrative, and political conditions.
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