title: Rural health care looks to the future. Issues in the institutionalization and management of rural health care: making technology appropriate.
abstract: Experimental projects have demonstrated the technical feasibility of systems of accessible, affordable health care. These projects have relied extensively on non-professional community health workers. However, large-scale implementation of these schemes will require new management procedures that are both responsive to rural health needs and congruent with national institutions. This paper identifies the need to establish institutional mechanisms to mobilize essential inputs, promote acceptance by beneficiaries, maintain quality standards, recruit and retain field staff, and achieve accountability for resources. It then outlines methods for developing these institutions. It stresses the need for both formal, bureaucratic organizations and informal organizations of clients. It also identifies the need to consider administrative and institutional resources in determining the appropriateness of a health care technology.
mesh_terms: D003906:Developing Countries; D006291:Health Policy; D006801:Humans; D013677:Medical Laboratory Science; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D012040:Regional Health Planning; D012423:Rural Health