An analysis of the population growth in the Seventh Five-Year Plan period.
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Efforts are being made to extend the practice of Community Oriented Primary Care by reorienting existing health services or restructuring medical education curricula. Nevertheless, changes in education must be simultaneous to changes in health services so that health professionals trained in COPC will find areas to practice COPC. The experience described in this article presents an effort in these two directions. A teaching program was introduced in a traditional medical school curriculum and was extended to six health services by training the directors of the health service as teaching instructors of COPC or closely coordinating actions with the director of the health service. The results of the program show fulfillment of learning objectives and student satisfaction with the program. Evaluations of the development of COPC in the health services involved show modifications in health programs to meet community needs and stronger community leadership and organization.
The AIDS pandemic is a human tragedy that is threatening development in the poorest countries. There is no cure or vaccine, but the tools to control the epidemic already exist. Nevertheless, there are few examples of national AIDS control programmes that have had an impact on the epidemic. We (an economist and a planner) attribute this to the reluctance of governments to confront AIDS and a failure to prioritise activities in the face of severe financial and administrative constraints. When implementation capacity is weak, expanding the number of activities may not improve programme effectiveness. Rather, by implementing a smaller, core set of the most cost-effective activities on a national scale, policymakers could have a huge effect on the overall epidemic in a sustained way and provide a foundation for expansion. We propose three core priorities for AIDS control in poor countries for prevention, treatment, and mitigation of the impact.
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