Principles of health infrastructure planning in less developed countries

This article proposes a number of key principles for health infrastructure planning, based on a literature review on the one hand, and on a process of internal deduction on the other. The principles discussed are the following: an integrated health system; a thrifty planning of tiers within that health system; a specificity of tiers; a homogeneity of the tiers' structures; a minimum package of activities; a territorial responsibility and/or an explicit and discrete responsibility for a well-defined population; a necessary and sufficient population basis; a partial separation of administrative and public health planning bases; and, finally, rules for a geographical division and integration of nongovernmental organizations. The definition of two strategies, primary health care and district health systems, is also revisited.