Selective primary health care: an interim strategy for disease control in developing countries

N Engl J Med. 1979 Nov 1;301(18):967-74. doi: 10.1056/NEJM197911013011804.

Abstract

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.

PIP: For major diseases for which control measures are inadequate, research is an inexpensive approach on the basis of cost per infected person per year. Priorities among the infectious diseases affecting the 3 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 diptheria-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. Aiming services at the most important diseases is the only rational approach to absolute proverty and unsanitary conditions. The goal is to help the greatest number of people in the cost effective method possible.

MeSH terms

  • Animals
  • Communicable Disease Control
  • Comprehensive Health Care / economics
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Developing Countries*
  • Disease Vectors
  • Health Planning / economics*
  • Health Priorities / economics*
  • Humans
  • Nutritional Physiological Phenomena
  • Parasitic Diseases / prevention & control
  • Preventive Medicine*
  • Primary Health Care / economics*
  • Research
  • Sanitation
  • Vaccination
  • Water Supply