Training and Management for Primary Health Care [and Discussion]

Training depends for its success upon initial selection of both student and teacher, and secondly on the curriculum content relevance to realistic job designations, consequent upon community appraisal, epidemiological surveys, manpower studies and facilities analysis. Examination systems should not be an encumbrance to real learning and the acquisition of appropriate skills. Management in primary health care depends for its improvement upon accepting that the delivery system is supportive to the primary health care unit rather than the reverse; that the structure of the delivery system and educational programmes correlate and form a simple referral chain and that data gathering be designed for a community information system rather than for centralized statistics. The two aspects, manpower development and delivery system, can be made more relevant one to the other by reconsidering the overall roles of the teacher and the practitioner. Supervision is a key issue and is primarily an educational activity, not administrative. Teamwork, to be effective, must be learned and instilled from inception of training. `Science resides in the intellect not the instrument'. (Abraham Flexner)