The guidelines provided incorporate principles and themes emerging from the re-evaluation of unsuccessful large-scale educational intervention programs in developing countries. Recommendations for effective programs include (1) a decentralized mode of operation, (2) local participation in designing and carrying out programs, (3) a multi-focus on…

If primary medical care is to be provided to remote rural populations in developing countries, alternative and innovative delivery systems emphasizing community participation, use of paraprofessionals, and health education programs must be considered. A recent American Public Health Association study of 180 health projects in developing countries…