[Cosmopolitan and traditional health systems: woman as the nexus]

The cost of extending health care to rural areas in developing countries has hindered efforts to bring cosmopolitan or "western" medicine into those areas. As a cost-effective and realistic strategy for expanding the services needed in the countryside-in a context of finite resources-the writer proposes making women agents of health care in the rural care system and giving them training that includes both formal and traditional practices. The process offers the woman, as a mother, the opportunity to play a leading part in evaluating the health status of her children and other members of her family. Based on the experience acquired in a rural health project carried out in the Altiplano of Bolivia, specific recommendations are made for application of this approach, which is based in the community itself, and the difficulties encountered in its practical application are cited.