A tension exists between objectives of health policy makers to achieve high quality standards of care on one hand, and district multi-crisis reality in sub-Saharan Africa on the other hand where sheer survival of the (public) health system is questioned.
The collapsing health services as well as the deteriorating living conditions affect the health status of the population and contribute to an increase in (health) inequalities both nationally and internationally.
Constraints and some examples of achievements in district health management in two districts in Northern Province, Zambia, are presented.
A strong focus on community-based health care, parthnership with communities and accelerated health-system support via strengthening of on-site supervision is advocated.
Decentralization and self-reliance are potential tools in flexible crisis management, but require continuity in human resource development and appropriate « care for the carer's ».
In order to increase operational efficiency, the need is expressed to conceptualize a practical approach of « minimum primary health care ».
Mots-clés Pascal : Soin santé primaire, Crise économique, Assurance qualité, Homme, Zambie, Afrique
Mots-clés Pascal anglais : Primary health care, Economic crisis, Quality assurance, Human, Zambia, Africa
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0152259
Code Inist : 002B30A01B. Création : 09/06/1995.