This strategy features in the framework of Agenda 21 as formulated at UNCED (Rio de Janeiro, 1992), now coordinated by the United Nations Commission on Sustainable Development and implemented through national and local authorities.
Governments should consider adopting enabling and facilitating strategies to promote participation by communities in meeting their own needs in addition to providing direct support to the provision of health care services. A major focus should be the preparation of community-based health and health-related workers to assume an active role in community health education with emphasis on team work, social mobilization and the support of other development workers. National programmes should cover district health systems in urban, peri-urban and rural areas; the delivery of health programmes at the district level, and the development and support of referral services.