Some links between successful implementation of primary health care interventions and the overall utilization of health services

All societies have need of a sick care system into which the general population has easy access. Such a system is required for the coherent organization of any health care service which is to be effective. Virtually all people want curative care when ill, but generally are less interested in preventive activities. It follows that a sick care service should be as widely available as it is hoped will be a preventive one. An effective sick service provides the basis of sufficiently regular contact with the bulk of the population so as to allow for the successful fulfillment of preventive health care goals. A shift is required from conventional input planning methods--more doctors, more health centers, etc.--to output planning; that is, actual utilization by the population of the services offered. The concern here is with the overall contact rate between the health service and the entire (relevant) population and not just the rate for any one particular health care program. Planning for additional inputs should be based on the expected outputs (contacts) which are expected to flow from those inputs. An average, well distributed annual utilization level of three to four contacts per capita should provide an adequate basis for fulfillment of preventive (and curative) goals in the health sector.