Matching goals and health care systems: an international perspective.
The author states that most health care systems fall short of the goal of providing care to all people in need or at risk, as evidenced by high morbidity and mortality rates in disadvantaged areas where 80% of the world population lives. This failure is seen as the result of a highly technical and centrally located health care structure wherein personnel and resources are most scarce at the levels closest to the community. It is suggested that "health for all" requires the development of a purposeful health care system for delivery of primary health care, and that the basic unit of the system should be local health service systems geared to the local conditions, including health risks and health resources. Community participation, generated by communication and education, is seen as essential for the local system. Reorganization of current Western style, centralized health care facilities would be imperative, though national centers for health care development would serve in an organizational and training capacity. It is proposed that the most important factor in bringing about these changes in the health system is a strong political will, supported at both national and community levels.