text: 13. A conference organized in 1980 by the Pathfinder Fund on "The non-physic ian and family health in sub-Saharan Africa" con­ sidered many aspects of PHC and how it should be implemented. The conference noted that health has always been a community responsibility, and that all peoples have from time immemorial taken steps to safeguard their health, and viewed the new ap­ proach of PHC as a revamping and revitalisation of an old idea to suit modern conditions in Africa. PHC offers a challenge to people to do something about their health: it is participatory, largely self-sustaining and relatively inexpensive. 14. A few countries have already started monitoring their com­ prehensive programmes based on the PHC idea. Malawi and Zambia are selected here for brief comment. 15. In Malawi a review of the PHC programme led to a modifica­ tion in the functions of the PHC workers in 1982. They had been trained to work as part-time multipurpose health cadres, but it was found that they tended to devote most of their time to sanitation, and neglected other tasks. ConseQuently, it was decided to train more part-time staff who would each handle a different set of tasks like promoting sanitation, or nutrition and nutritional surveillance, or communicable dise!ase control, or the functions of a traditional birth attendant or Didwife dealing mainly with maternal care. 16. The PHC workers are given a small monthly stipend by the Malawi Government, but if the system expands to cover the whole country the costs will be enormous. Consequently consideration is being given to plans to encourage the village communities to provide such rewards themselves. 17. A review of the Zarrbian programme jointly undertaken by the Zambian Ministry of Health, SIDA, UNICEF and tmo revealed a variety of problems in t~e PHC systems. PHC requires the exten­
analysis: The text primarily discusses the concept of Primary Health Care (PHC) and its implementation in sub-Saharan Africa, specifically in Malawi and Zambia. It highlights the participatory and self-sustaining nature of PHC and the challenges faced in its implementation. The text also touches on the need for community involvement and the potential costs associated with expanding the program.