Community health intervention program (chip): re-educating health professionals for primary health care

Primary health care (PHC) in most developing countries remains largely inaccessible to a vast proportion of urban and rural populations. It is neither influenced by, nor integrated with, preventive care/community development. This may be attributed partly to lack of community participation by communities. Professional health care is isolated and impervious to the influence of health care users. In Nigeria all functional correlates are available in the existing health systems; yet, the impact is not felt. What is needed, and urgently, is an intervention to extend meaningful health care delivery into the urban poor and rural communities. The Nigerian Youth Service Corps (NYSC) scheme, through a rational and systematic mobilization and utilization of its health manpower, offers an excellent opportunity to demonstrate that PHC can work. A two-step intervention process is proposed: a reorientation during NYSC "orientation," and a community-based practice module, during the NYSC "Primary Assignment" phase. Health professionals working as a "team," and led by NYSC doctor(s), undertake their medical care responsibilities as well as community development projects as integrated aspects of PHC. It is envisaged that experiences accruing from such a deliberate intervention with a pilot project, will form a basis for operational adoption of the proposed CHIP as a national model.