Government health services versus community: conflict or harmony

From their daily experiences with PHC implementation in Mali, the authors discuss the relation between the government oriented basic health services (BHS) and the community health services (CHS) practised at village level. They question the general assumption that the two 'systems' work harmoniously together to improve the health of the rural population. They argue that the workers within the BHS have little interest in the health of the rural population for economic reasons, for reasons of training and background, for reasons of their own curative interests and finally for reasons inherent to the BHS organisation. Thus the BHS are not likely to respond to the essential needs and problems of the CHS. Some suggestions for what can be done in such a situation are made.