PIP: When the government of Djibouti established its national health development plan for 1991-95, it took into account traditional medicine, services founded in the colonial era, and the need for primary care. Djibouti needs more physicians. As such, students should be encouraged to pursue medical studies. Efforts to train paramedical staff, the need to integrate the traditional sector into the health system, disease prevention programs, the need to modernize the General Peltier Hospital, maternal and child health, measures being taken to increase the level of community participation in health care, and the adverse effect upon service quality of providing free medical care are discussed. Drug supplies have dwindled as population size has grown. In general, the country's health facilities are overburdened and their equipment is breaking down. In this context, the community must assume part of the financial responsibility for health care.