This book is concerned with orienting health care workers in district health systems in developing countries to ways and means of overcoming problems, and describes briefly how district health systems can be improved. The book is organized around nine issues in nine chapters, each of which is an integral part of a district planning cycle. The opening three chapters show how to assess the existing district health system in terms of national policies and support, analysis of the current system, and evaluation of district priorities. Chapters 4 through 7 focus on actions to be taken. The initial task of setting goals is discussed using examples and establishing general categories. The book next treats the action program including curative services, maternal and child health and health promotion, and prevention and control of disease. The next chapter focuses on the increase in program effectiveness brought about by joint action of families, individuals, and communities. Chapter 7 discusses key issues pertaining to good operational management. The final two chapters focus on monitoring (i.e., the use of tracer diseases and sentinel sites) and tips for evaluating interventions and learning from experience. Nine figures, 10 tables, and practical examples and case histories accompany the text. A list of 12 references is appended. (JB)