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General practice: unity in diversity

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Most of the world is yet to have access to any effective form of primary care. This is a tragedy created by lack of practitioners and infrastructure, prohibitive fees, and indifference to the plight of the poor. About 300 000 mothers, many of them teenagers, die each year in childbirth for lack of simple primary care in the least economically developed nations (http://www.who.int/mediacentre/factsheets/fs348). But there are encouraging signs. In the 6 years I have been visiting India as part of a review team invited by the Ministry of Health, I have seen maternal mortality reduced by women in remote villages — trained for a couple of days and equipped with no more than a mobile phone and a bicycle — who help pregnant women gain access to safe environments providing postpartum treatment and basic support for mother and child (http://www.nrhm.gov.in/monitoring/international-advisory-panel/minutes-of-the-international-advisory-panel.html). There are now 800 000 of these women working in India. Simple changes that take account of local needs and conditions can have a huge effect.

Australia has about…