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( By J.-J. Guilbert )

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Chapter 1: Priority health problems and educational objectives - The road to relevance


Mapping reality

Mapping reality means identifying the factors that have an impact on the health of the community; in other words, getting on the road to relevance.

Identifying the health problems of the community
Identifying the overall goals of national health policy
Identifying support systems
Identifying institutional goals
Identifying the “players” in activities relating to health

Personal notes


What is meant by relevance?


The most important quality in an educational programme is its relevance. Training programmes for health personnel must enable the graduates to cope effectively with the problems they will encounter in the context of their work.

The first step is therefore to identify and analyse the health problems of the community so as to be able to define the community's health needs. These elements will serve as the starting point for the design of an educational programme.

A first comprehensive assessment of health problems will bring to light so many complex problems that it would be impossible (and probably futile) to include them all in an analysis of the health situation. It will therefore be necessary to define priorities and select those that are regarded as most important for an educational programme.

These factors should then be examined to see how they interact, or in other words, to make a causal analysis.


Rank (in order of priority1) the health problems in your own community.

1 Use criteria 1, 2 and 3 given at the top of page 3.52.

High-priority community health problems



Make a causal analysis of the priority health problems you have identified.



You may now wish to reconsider the order of priority you had established.

Identifying health policy orientation


Most countries have developed some sort of policy orientation to address health problems. But they may not have formulated any explicit goals. If your country has not set itself any health goals, it would be useful to review existing national plans in areas with some relation to health, such as nutrition, agriculture or education, in order to derive an idea of the country's general goals for health.

You should now obtain copies of your country's relevant documents on these questions.


On the basis of your country's plans, identify the general national goals that relate to the health situation. Compare them with the health problems you have already identified (page 1.09)

General national goals for health