The Aga Khan Health Services (AKHS) is one of the most comprehensive non-profit health care systems in the developing world. Building on the Ismaili community's health care efforts during the first half of the century, AKHS now provides primary health care and curative medical care in India, Pakistan, Kenya, Tanzania and Syria. It includes five general hospitals, the Aga Khan University Hospital in Pakistan, six maternity homes and more than 230 health centers. Organized in national service companies in Kenya, Tanzania, India and Pakistan, these health facilities are also linked in internationally through network-wide strategies in human resource development, hospital management, nursing development and primary health care.

AKHS's primary health care programmes are designed to reach vulnerable groups in society, especially child-bearing women and young children, with low-cost medical technologies of proven effectiveness: Immunization, systematic prenatal care, aseptic deliveries and oral dehydration therapy for diarrhoeal disease. Experience with PHC within the Aga Khan Development Network, where AKHS works closely with both AKF and the AKU, has confirmed both the efficacy of primary health care in improving health status, and its cost-effectiveness.

In AKHS's approach to health services, primary health care and prevention are steps toward improved health status that must be linked to the availability of high quality medical care. To complement its work in primary health care, AKHS offers curative services in institutions ranging from dispensaries through health centers and maternity homes to full-service hospitals. At each level of care, AKHS's focus is on providing services that are needed and wanted by the community and upon building linkages within the system. It also aims to ensure a quality of care that significantly raises local standards. Quality control in laboratory diagnosis, good do*****entation in medical records, regular supply of pharmaceuticals and continuing education of nurses and doctors are some of the practices that AKHS emphasized in its approach to institutional development.

While strengthening its institutions and the links between them, each National Health Service Company joins government health services and other providers in building effective national health systems. Welding the national service companies into an international system is also an AKHS goal. Current projects with possible implications for the network as a whole include the introduction of selected clinical care interventions into PHC programmes in the Northern Areas of Pakistan, attempts to build regional referred arrangements in East Africa, and experiments with resource sharing within the AKHS, in the attempt to provide the very poor with better access to care. Many of these experiments involve close collaboration between the AKHS, AKF and the AKU.