ABSTRACT
PIP: The rates of infant and under-five mortality are too high in India. Almost half of these child deaths could, however, be avoided with greater primary health care. Evidence from other countries demonstrates the potential of primary health care programs to slash infant mortality by 50-60% over a 1-5 year period. Such programs should consider: prenatal care; delivery by trained birth attendant; care of newborn infants; primary care for diarrhea, acute respiratory infections, and other common diseases; immunizations; prophylaxis against anemia and vitamin and iodine deficiency; growth monitoring and nutritional guidance of staff; and stronger secondary and tertiary care. While components of this program may be in place, inadequate staff training and essential medicines and equipment combine with poor infrastructure, communication, and supervision to produce inadequate service coverage. This paper proposes the employment of female multipurpose workers to provide both primary health care and family planning services to rural communities. Each worker would be responsible for services in 5-6 villages of 5000 inhabitants within a 5-km radius of her headquarters. Elements of the program are discussed in the bulk of the paper.^ieng
