BMJ  2004;329:1186 (13 November), doi:10.1136/bmj.329.7475.1186

Letter

Learning from low income countries: what are the lessons?

Improvement can occur even in resource constrained settings

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

EDITOR—Berwick's editorial on the lessons from developing nations on improving health care mistakenly abstracts improvement efforts from the complex context of poverty and inequality.¹ Improvement is "an inborn human endeavour," yet an under-nourished or sick child who wants to "jump higher or run faster" cannot do so unless basic needs are met first.¹ In Peru we learnt that notable improvement can occur, even in resource constrained settings. But it takes more than goodwill. Aims, teamwork, and ability to do more with less and handle the political interface are important but insufficient. Consequently, some of the lessons mentioned should be read with caution. What may be waste in wealthy settings may not be so for impoverished ones.

"Dependency is waste." This is not always true. Sometimes, reliance on donor funds may be the only means of providing or improving health care for poor people. Wealthier nations and organisations providing . . . [Full text of this article]

RSapag_SES@pih.org, Socios En Salud Sucursal Perú, Avenida Merino Reyna 575, Carabayllo, Lima 6, Perú

JBayona_SES@pih.org, Socios En Salud Sucursal Perú, Avenida Merino Reyna 575, Carabayllo, Lima 6, Perú

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