Presents reports of widely diversified efforts to implement primary health care in Zambia. By looking at a range of different approaches and analysing the reasons for their successes and failures, the book aims to provide lessons that can help other countries set realistic goals, develop well-conceived plans, and avoid common errors. All contributors from frontline workers for nongovernmental agencies to officials in the Ministry of Health write on the basis of extensive personal experience with primary health care in Zambia. Their experiences combine to provide unique insight into the complex process of establishing a health system, in a least developed country, based on primary health care. All contributors share the conviction that the principles of primary health care, beginning with equity, remain the only means of achieving a meaningful improvement in the health of entire populations. The main part of the book presents first-hand accounts of various projects implemented over the past fifteen years. These include a pilot project to improve environmental sanitation in villages, Oxfam s grassroots experiences with primary health care, efforts to stimulate self-help in a poor and sparsely populated district, and the promotion of community involvement in AIDS care and prevention. Efforts to improve the management and monitoring of primary health care are also described. Other chapters discuss the role of traditional healers as a resource for primary health care, and summarize key problems encountered in most of the projects described. In the final chapter, a team from the Zambian Ministry of Health describes its vision for future health care and frankly confronts a number of controversial issues.

DC.HQ

eng fre.

WHODOC

WHO monograph

4