International health planning: socioenvironmental dimensions and community participation

The emphasis of the last decades on a systems approach to planning should foster adequate consideration, in health planning, of the influence of nonhealth factors on health conditions and services. However, the health professions, sometimes on 'international standards' grounds of questionable relevance, have been rather long in recognizing that medical care in the developing world is not only an 'exotic byproduct' of Western practices. The importance of going beyond the traditional tropical medicine concerns has been indicated: the main determinant of the pattern of medical care in developing countries is poverty rather than a warm climate. This is true not only of medical care, but also to a large extent of the health problems. Others have aimed at fostering the same awareness, as have technical assistance agencies like WHO. Yet, it still needs to be emphasized that most of the ills of public health importance in developing countries are basically socioenvironmental in nature.