| Developing countries face a quality-quantity dilemma in choosing a suitable type of medical care - the "philosophy of the best" versus the "philosophy of the most." To have any significant impact on standards of health, related services must attempt to a achieve a total outreach as rapidly as possible. However, the demand for new knowledge and new technologies to treat individuals is in conflict with the wider application of existing knowledge and techniques to treat the impoverished majority. The physician must play his part as a member of the community development team, but professional health personnel are expensive both to train and to employ. The development of simple criteria for diagnosis, treatment, and aftercare, combined with a system of referrai and supervision, will permit auxiliary health workers to perform many of the physician's functions at a lower cost. The auxiliary has a lower level of education but is trained for specific work, in the use of selected tools of medicine, and to a predetermined level of competency. The author discusses the ways in which economic and social characteristics common to developing countries favour this approach, although national attitudes to the use of auxiliaries are varied. He also provides definitions of some frequently used terms: "professional," "subprofessionai," "paramedical," "auxiliary," "ancillary," "traditional healer," "traditional midwife," and "medical assistant." |