Learning from low income countries: what are the lessons?: Communities should decide priorities

doi:10.1136/bmj.329.7475.1183

BMJ 2004;329:1183 (13 November), doi:10.1136/bmj.329.7475.1183

Letter

Learning from low income countries: what are the lessons?

Communities should decide priorities

The first 150 words of the full text of this article appear below.

EDITOR—Women and children continue to die needlessly indeveloping countries. We know the causes but seem powerlessto prevent their deaths. Constraints within health systems areblocking improvements, and we don't know enough about how tostrengthen and sustain them without external investment. Individualsand communities have their own priorities for health, and aglobal solution for disease and poverty is impossible to prescribe.

A village was asked by an aid agency what its priorities fordevelopment aid would be, the answer presumed to be a healthcentre, school, or irrigation system. When the villagers repliedthat they wanted a football pitch, the agency withdrew its offer.The villagers built their own football pitch, and this engenderedsuch a feeling of community spirit that they built their ownhealth centre the next year without outside help.

During famine we concentrate on nutritional supplementationfor children under 5 years . . . [Full text of this article]

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Paul Eunson, consultant paediatric neonatologist

Royal Hospital for Sick Children, Edinburgh EH9 1LF Paul.Eunson@luht.scot.nhs.uk