Manpower for health services with special regard to primary health care

The World Health Organization recently reoriented its HMD program. Its aim is to collaborate with the 150 member states in their efforts to make the HMD process (planning, "production," management of health personnal) relevant to the needs of well planned health services. On the basis of this principle, properly planned PHC services should be manned by health teams in which each member is responsible for, and prepared to carry out, certain well-defined tasks to cover primary preventive, promotive, curative and rehabilitative health needs of the entire population. After an overview of the present situation and solutions which are often largely medically biased, a logical approach is proposed. On the basis of a functional analysis, job patterns should be defined for each worker in the PHC team on the principle that all health activities should be undertaken at the most peripheral level of the health activities as is practicable, by the workers most suitably, and not most highly, trained to carry out those activities. Health manpower plans should then be translated into training programs to help the learners to prepare themselves, and motivate them, to meet the challenges of PHC. Proper management of PHC teams is equally important to ensure both job satisfaction of team members and "consumer" satisfaction and improvement of health status for the people.