Selective primary health care: the counter revolution

Area of Science:

• Public Health
• Health Systems Research
• Social Determinants of Health

Background:

• The failure of the Malaria Eradication Programme indirectly catalyzed the development of primary health care.
• A significant ideological shift occurred, redefining health services beyond mere intervention delivery to encompass individual and group importance.

Purpose of the Study:

• To analyze the ideological underpinnings and core principles of the primary health care movement.
• To examine the evolution of health service structures in response to the primary health care paradigm.
• To critique approaches that prioritize selective interventions over the foundational ideas of primary health care.

Main Methods:

• Conceptual analysis of the historical development of primary health care.
• Examination of the ideological shifts and their impact on health service delivery models.
• Comparative critique of broad primary health care principles versus selective intervention strategies.

Main Results:

• Primary health care (PHC) evolved with core values of power, ownership, equity, and dignity.
• The ideological shift necessitates new organizational structures for health services, many still under development.
• Advocates of selective, managerially driven health interventions have sidelined the revolutionary aspects of PHC.

Conclusions:

• The primary health care revolution is characterized by a fundamental ideological change, not just service delivery.
• Current selective health intervention strategies often contradict the core principles of equity and dignity central to PHC.
• A re-emphasis on the foundational ideas of primary health care is crucial for its successful implementation and true revolutionary potential.