Radiological services throughout the world

WHO's statistics show the doctor-to-population ratio in the Third World to have changed very little over the past decade, with radiological services among the least developed medical branches of a developing country's health care system. Data is presented on population/machine/personnel ratios, morbidity patterns, number of X-ray examinations per population and films taken, percentage of wasted film, and breakdown of types of procedures. Data collected from 89 countries show that of a total population of 1.2 billion, only 220 million have access to adequate diagnostic X-ray services. A well-structured diagnostic X-ray service at the country level should form a pyramid consisting of three levels of sophistication: (1) Basic Radiological Service (BRS), the broad base of the pyramid and available to the mass of the population requiring uncomplicated radiographic examinations; (2) General Purpose Radiological Service (GPRS), at the intermediate level, functioning as a backup service for the BRS facility and a filter station for the sophisticated department at the top; (3) Specialized Radiological Service (SRS), performing specialized radiodiagnostic procedures, and undertaking research and training. This pyramid structure does not at present exist in the majority of countries. Adequate coverage of the population cannot be achieved unless X-ray facilities are made available in places near to where the majority of the population live. The BRS comprises a technical concept and teaching/learning programme representing a solution to the present unsatisfactory situation.