For Better Health: More Schools or Hospitals?

To improve health would you build more schools or hospitals? Truth to tell, I’ve never thought of it as either/or. Most likely I would choose more hospitals. But I’d be wrong.

Christine Gorman at Global Health Report blog summarizes findings from health surveys that demonstrate "education, social support and early childhood development play a more important role in overall health in a country than the condition of its hospitals and other health services."

Advocates of community-based health programs know the value of social support, education and early intervention in maternal child health. But their concern is simply to get effective, rudimentary care to people lacking even basic services. Generally it’s not about building schools or hospitals.

Ultimately that’s not the choice anyway. It’s about measuring effective intervention. I’m taking Christine’s post in a different direction. It made me think about a couple of questions: What improves the quality of health? Could rudimentary but effective intervention be as valuable to improve community health as hospitals or clinics?

Stated differently, community involvement in health through good information, communication and support can produce positive results. My hunch is this research is confirming that grassroots connections in the community carry significant weight in both health education and practices.

And if this is true, it means community-based, participatory health programs can make a big contribution to good health, even when hospitals and health systems are lacking. That’s no excuse for neglecting national health care systems that are already deficient. But, it is a reason to make note of the potential benefit of less expensive and complex health interventions. And these are strengths of many non-profit and faith organizations’ health efforts.

They also point to the value of maternal child intervention. The Measles Project has been effective because it incorporates training, information, vaccinations and multiple additional inputs including providing mothers with bednets to prevent malaria. Vaccinations are community events where mothers receive instructions about using nets and identifying the disease’s symptoms.

Finally, the issue isn’t about choosing between schools or hospitals. Both are needed. But community-based efforts combined with on-going support are also valuable. With the right kind of support the capacity and resources of poor communities can be mobilized for better health.

More schools or hospitals? For better health the probable answer is both, and more.

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