Bloom G
Int J Health Serv. 1985;15(3):451-68. doi: 10.2190/KV70-AKEG-Y1JE-KLNE.
The health situation in pre-Independence Zimbabwe was much as elsewhere in the Third World. While the majority suffered excess mortality and morbidity, the affluent enjoyed a health status similar to that of the populations of developed countries. The health services also showed the familiar pattern, with expenditure concentrated on sophisticated facilities in the towns, leaving the rural majority with practically no services at all. With the coming of Majority Rule, the previous pattern of controlling access to facilities on the basis of race could not continue. Two broad routes forward were defined. On the one hand, the private doctors, the private insurance companies, and the settler state proposed a model based on improving urban facilities, depending on a trickle-down to eventually answer the needs of the rural people. On the other hand, the post-Independence Ministry of Health advocated a policy of concentrating on developing services in the rural areas. The pattern of the future health service will depend on the capacity of the senior health planners and on the enthusiasm of front-line health workers but, of overriding importance will be the political commitment to answer the needs of the majority and the outcome of the inevitable struggle for access to scarce health sector resources.
独立前的津巴布韦的健康状况与第三世界其他地方大致相同。虽然大多数人遭受着过高的死亡率和发病率，但富人的健康状况与发达国家的人口相似。卫生服务也呈现出常见的模式，支出集中在城镇的先进设施上，使得大多数农村地区几乎没有任何服务。随着多数统治的到来，以往基于种族控制获取设施的模式无法继续。确定了两条大致的前进路线。一方面，私人医生、私人保险公司和殖民政府提出了一个基于改善城市设施的模式，指望涓滴效应最终满足农村人民的需求。另一方面，独立后的卫生部主张实行集中发展农村地区服务的政策。未来卫生服务的模式将取决于高级卫生规划者的能力以及一线卫生工作者的热情，但最重要的将是满足大多数人需求的政治承诺以及获取稀缺卫生部门资源的必然斗争的结果。
