In general, attempts to solve Africa’s health problems have failed to appreciate that socioeconomic and health care measures must to some extent operate in tandem. Colonial health care systems were oriented towards curative services. On independence, governments inherited centralized, city-based health services geared to meet the needs of the urban elite and excluding people in rural areas. In 1977, a new strategy of primary health care was introduced by the WHO, encompassing a decentralized, hierarchical, basic health system, together with community participation and an increased intersectoral emphasis on essential basic preconditions for health such as adequate food and water supplies. This paper looks more closely at three countries that have adopted the concepts of primary health care, put forward appropriate policies, moblized resources and implemented programmes that have led to improvements in the health of their populations, viz. Botswana, Tanzania and Zimbabwe. In general, Africa’s success in improving health has been both uneven and limited in scope. The main problems involved are inadequate economic support, lack of internal efficiency, unequal access to modern medical care, and a piecemeal approach. Note, ref.
