This chapter is extracted from:

Unger J.-P., De Paepe P., Green A. A code of best practice for disease control programmes to avoid damaging health care services in developing countries. Int J Health Planning and Management 2003; 18: S27–S39.

Continuing with some of the essential tenets in the management and delivery of health care, we suggest some principles, designed to avoid aspects of disease-control programmes. These have caused much consternation and challenge for both health practitioners and policy makers, facing different pressures, from donors and the public.

From our own research over the past three decades, we are able to tentatively propose four essential principles that might help avoid disease-specific programmes putting unnecessary pressure on quality health care systems. Through this we also suggest means to improve access to CHC in LMICs.

Disease-control activities should generally be integrated, with the exception of certain well-defined situations. They should be integrated in health centres, which offer patient-centred care

As discussed above, justification for this requirement is two-fold. The early detection of chronic diseases (such as tuberculosis and AIDS) and of acute conditions (such as severe malaria, childhood acute respiratory infections, diarrhoeal diseases) is hindered by low primary care utilization rates. In practice patient loyalty can only be created by good quality primary care. In addition improved doctor/patient communication should result in enhanced continuity of care and better cure rates. Still, there are exceptions for which a vertical organization is still appropriate (see above).