[Community medicine in developing countries].

Abstract

Community medicine (CM) addressing the global problems of human health has been intensifying in concert with primary health care (PHC) in developing countries, especially since the 1977 session of the WHO launched a program called "Heath for all by 2000" whose central component was PHC. An international conference in Alma Ata in 1978 on PHC stressed essential health care for all communities supported by practical methods that were scientifically valid and socially acceptable, assistance that was accessible to all members of the community. The objectives of PHC were: promotion of proper nutrition, safe water supplies, basic hygiene, maternal-child hygiene, vaccination against major infectious diseases, prevention and control of endemic local diseases, health education, and proper treatment of common diseases and injuries. A PHC post on the village level of Cm would have 1 community health worker (CHW) and 1 traditional birth assistant (TBA) providing health care for 500-1500 people. On the district level, a PHC unit would have 2 CHWs and 2 TBAs for 10,000 people. On the regional level, a PHC center would have 1 physician, 2 attendant nurses, 2 obstetricians, 1 technician, 1 pharmacist, and 1 administrator. Finally, on the national level, hospitals would take care of health needs. The lack of properly trained staff and resources poses the biggest problem in the organizational structure of Cm, but this could be overcome by collaborating with rural medicine and traditional medicine.