Primary Medical Care in Developing Countries

Abstract

Common to all developing nations are lack of financial resources and of trained manpower, illiteracy, high fertility, a traditional society based on the soil, and diseases related to undernutrition, infections, and vector–borne illnesses. Most diseases are not of the exotic, tropical kind but common diseases of the respiratory and digestive tracts. There is much less self–treatment than in industrialized nations, but many complaints could be treated by nonphysicians. The distribution of scarce physician resources is poor. Most seek to live and work in capital cities and not in the rural areas where most of the people live. There are too few paramedical workers to support the physicians. The growth of the population constantly exceeds the growth of new physicians, some of whom are lost through the brain drain to more developed countries. While there is no lack of knowledge or understanding of what to do about these problems, there is insufficient application of such knowledge toward practicable solutions. More realistic planning for primary care is necessary in the future. The only hope lies in greater use of nonprofessional workers operating from planned centers. Among the priorities are screening for early major abnormalities, better emergency care and transport services, and birth control. More emphasis must be given to child care in rural areas, where children under 15 account for more than half of the population.