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Doyal and Gough's Needs


Explanations > Needs > Doyal and Gough's Needs

Health needs | Autonomous needs | Intermediate needs | PreconditionsSo what?


Len Doyal and lan Gough differentiate between basic health needs and the more cognitive autonomous needs, and have created a useful list of intermediate needs. Their model also considers the satisfaction of needs for entire groups as well as for individuals.

Health needs

Physical health needs are the fundamental requirements in order to stay alive. For this you first need food and water. It is also important to avoid situations where you may be killed or hurt. The person also needs to not catch diseases.

Overall, the nature of what we do with regard to these needs is around avoiding harm.

As with Maslow's Hierarchy, health needs are most important and will take precedence when they are threatened or impacted.

Autonomous needs

Overall, the nature of action with regard to autonomous needs is around making informed choices to achieve conscious goals. To make these choices, a person needs three attributes:

  • Mental health
  • Cognitive (thinking) skills
  • Opportunities to engage in social participation

We are all driven by cultural and social norms and so autonomous needs are closely related to esteem. We need both to obey these norms and also to identify personal goals towards which we can work.

Critical autonomy is about going beyond the constraints of culture that can easily limit the choices that a person makes, and which acts as unspoken and assumed boundaries. Breaking social and cultural rules can require significant courage.

Intermediate needs

Doyal and Gough identify eleven 'intermediate needs' (or universal satisfier characteristics) for things that are essential for basic needs and enable autonomous needs to be satisfied.

  1. Adequate nutritional food and water
  2. Adequate protective housing
  3. Non-hazardous work environment
  4. Non-hazardous physical environment
  5. Appropriate health care
  6. Security in childhood
  7. Significant primary relationships with others
  8. Physical security
  9. Economic security
  10. Safe birth control and child-bearing
  11. Appropriate basic and cross-cultural education


Needs do not just simply result in action and there are both procedural and material preconditions that must be satisfied.

Procedural preconditions are about the ability to identify needs and ways of satisfying them. Where there are groups of people involved, this requires discussion and agreement, including the resolution of any conflict around these.

Three procedural preconditions are hence identified:

  1. Rational identification of needs
  2. Use of practical knowledge to identify needs satisfiers
  3. Democratic resolution for agreement by stakeholders

Material preconditions are about the capacity to produce and deliver need satisfiers.

Four material preconditions are identified:

  1. Production of satisfiers, efficiently
  2. Distribution to individuals with separate needs
  3. Needs transformation, turning the satisfiers into satisfaction
  4. Material reproduction within the process, including use of time and goods

So what?

The principle of autonomy is a useful consideration in persuasion where you can give the other person choice and hence not create reaction.

The intermediate needs list is a useful checklist of things to check, for example a person who has limited economic security will be more concerned about pricing.

See also

Doyal, L. and Gough, I. (1991).  A Theory of Human Need, New York: Guilford.

Gough, I. (1994) Economic Institutions and the Satisfaction of Human Needs. Journal of Economic Issues. 28, 1 (March 9), 25–66


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