| Abstract: | In 1978 the health status of Kiribati was reported as one of the worst in the Pacific with a comparatively high infant mortality rate and a low life expectancy at birth. Since 1981, a nationwide primary health care development project has been set in motion. This article summarizes the activities of this project. A working group identified 28 major factors that had been responsible for failure to improve the situation. Orientation courses were held for all health staff and during the following year courses were given for long-term primary care workers. The communities decided how they would tackle the identified problems and appointed working committees that have now become village welfare groups. The communities are implementing the project on a voluntary basis. There have been reductions in morbidity associated with many of the most common diseases, in hospital utilization costs, and family planning coverage has increased sharply. A mechanism for program improvement in the form of regular monitoring, evaluation, research and review exercises has been developed. |
