Health services can be decentralized by the use of basic health care clinics (the most peripheral level of health care) providing simple treatment using the basic units. Such a decentralization will: (1) increase the access of the population to curative care; and (2) avoid overcrowding of referral facilities by solving common health problems at the most peripheral level. Basic treatment protocols have been drawn up to allow these health workers to take the right decision on treatment or referral, according to the symptoms.
The first referral level should be staffed by professional health workers, usually medical assistants or doctors, who will use drugs, supplies and equipment from both the basic and the supplementary units. It should be stressed here that the basic and supplementary units have not been intended to enable these health workers to treat rare diseases or major surgical cases. For such patients a second level of referral is needed, usually a district or general hospital. Such facilities are normally part of the national health system and referral procedures are to be arranged with the local health authorities. The UN list2 of medical supplies, equipment and drugs is intended to supply this level of the health care system.
2UNDP. Emergency relief items, compendium of basic specifications, vol. 2. Medical supplies and equipment, selected essential drugs, guidelines for drug donations. New York: United Nations Development Programme; 1996.