The development of the health services in the majority of underdeveloped countries during the colonial period, and immediately after independence, have concentrated on providing a largely hospital-based curative programme. This has also included training of the local population, particularly as nurses, to carry out this programme. Figures show that, for the African region of the World Health Organization (WHO), nursing personnel form a significant group of trained health manpower (WHO 1973).

The objective of this paper, therefore, is to raise the question of whether nurses in underdeveloped countries should continue to be trained mainly for their traditional tasks of caring for the sick in hospitals, or whether the majority of them should be channelled into other types of work more appropriate to the major needs of the population. In order to reach this objective, an example is given of the Tanzanian experience 15 years after independence, including a description of a community health project involving a group of student nurses in the rural areas of mainland Tanzania.