In spite of planned development and expansion of health services, especially in rural areas in India, mortality due to preventable conditions has remained unacceptably high. Important reasons for failure of the health system to detect the problems early are centrally planned programmes based on inadequate data and time-bound numerical targets for achievement. This promotes a tendency for passive implementation which destroys initiative and incentive for conceptualisation of problems and strategies. For health programmes to be far more successful, the entire health team needs to be given training in epidemiology appropriate to the level of each category, so that programme planning based on epidemiologically determined local needs can be done at district level by the District Health Organisation. Participation of health workers and the community will then be more active and relevant to the needs of the community.
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