[Does selective intervention affect other areas of primary health care? Evaluation of a vaccination program in Somali...

The discussion, whether poor countries of the third world should work towards comprehensive or selective primary health care has been based on political and economical arguments. The present study examines how far a selective strategy with one target problem influences other areas of primary health care. The study is based on the experiences with a vaccination program in the Somalia refugee camps. The program produced for the first time a reliable census of the refugee population which produced much smaller figures than had been reported previously. Data on the nutritional status of all children under 5 was collected at the vaccination places. These data provided a new basis for the general food distribution. At the same time the data served to evaluate the supplementary feeding program for vulnerable groups. The study also showed that general food distribution was more important for the reduction of malnutrition than other interventions, such as curative health care, community water supplies, sanitation, supplementary feeding program and vaccination program. Furthermore it illustrates the conditions in which sectorial actions can become a useful asset to community oriented health programmes.