[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
December 6, 1985

The Demand for Primary Health Services in the Third World

Author Affiliations

Harvard School of Public Health Boston

JAMA. 1985;254(21):3111. doi:10.1001/jama.1985.03360210127053

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Making services available does not ensure that they will be used; "supply" is a necessary but not sufficient condition for utilization. For example, the establishment of up-to-date government-run health clinics in less-developed countries does not guarantee that the poor will receive modern medical care.

As economists, Akin et al focus on the "demand" for primary health care. Their book attempts to identify the crucial factors affecting actual consumption of available health services in the Third World.

After reviewing the diverse and often noneconomic theoretical and empirical literature, the authors analyze data from the Bicol region of the Philippines. Surprisingly, there is no dearth of medical resources available in this poor rural area. The sick have a variety of options; the book tries to explain statistically their choice among self-help, traditional providers, modern private practitioners, and government clinics.

The government clinics are nominally free, but there are drug prices, transportation expenses,