SELECTIVE PRIMARY HEALTH-CARE - INTERIM STRATEGY FOR DISEASE CONTROL IN DEVELOPING-COUNTRIES

Priorities among the infectious diseases affecting the three billion people in the less developed world have been based on prevalence, morbidity, mortality and feasibility of control. With these priorities in mind a program of selective primary health care is compared with other approaches and suggested as the most cost-effective form of medical intervention in the least developed countries. A flexible program delivered by either fixed or mobile units might include measles and diphtheria–pertussis–tetanus vaccination, treatment for febrile malaria and oral rehydration for diarrhea in children, and tetanus toxoid and encouragement of breast feeding in mothers. Other interventions might be added on the basis of regional needs and new developments. For major diseases for which control measures are inadequate, research is an inexpensive approach on the basis of cost per infected person per year. (N Engl J Med 301:967–974, 1979) THE three billion people of the less developed world suffer from a plethora of infectious diseases. Because these infections tend to flourish at the poverty level, they are important indicators of a vast state of collective ill health. The concomitant disability has an adverse effect on agricultural and industrial development, and the infant and child mortality inhibits attempts to control population growth. What can be done to help alleviate a nearly unbroken cycle of exposure, disability and death? The best solution, of course, is comprehensive primary health care, defined at the World Health Organization conference held at Alma Ata in. © 1979, Massachusetts Medical Society. All rights reserved.