It has often been suggested that the focus on qualified doctors is one of the main reasons behind the lack of health care in rural areas. In 1975, the Group on Medical Education and Support Manpower suggested that there was a need to reorient medical education and develop a curriculum for health assistants who were to function as a link between medical staff and multi-purpose workers.

The work in the B R Hills of Karnataka by H Sudarshan, a medical doctor, on the primary healthcare of the Soliga tribes is a rare example of the role of equity, social justice, maximum community participation and empowerment of the people, in addition to the encouragement of indigenous and traditional systems of medicine, in a successful community health programme.