Campaigns and General Programmes

Communicable diseases can be controlled by campaigns (called special programmes by WHO) or made a function of the general health services. Special campaigns have the attraction of putting all the effort into one particular disease, often with considerable initial success, but over the long term, breaking down again. Integrating the control method with the general health services often gives a more consistent result. The advantages and disadvantages are as follows:

General health Campaigns services

Effectiveness

Initially very

Only moderate

good

Continuation

Poor

Moderate

Duration

Short

Long

Staff

Special

General health

required

workers

Salary

Inflated

Average

Staff problems

No career

Addition to

structure

routine duties

Cost

High

Low

Integration

Low

High

It is the integration of the campaign into the general health services that destroys the good progress made. There are difficulties of emphasis, staff absorption and resentment by the multi-purpose worker. Campaign workers are often specially recruited for the task, probably from non-medical backgrounds and are paid inflated salaries to offset the time-limited nature of the operation. The general health services are not used to dealing with the special disease and feel they are being given extra work, while still being paid the same. An alternative might be to use the general health ser vices for a brief special effort, which can continue to be maintained in their routine services. An example is a mobilization of the general health services to do a mass vaccination campaign before the start of the rainy season (Section 3.2.6). For the rest of the year, they can continue with the routine vaccination programme.

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