Structural conflicts in the neighborhood health center program: the national and local perspectives

The paper reports the findings of a study of the neighborhood health center (NHC) program which was initiated by the Office of Economic Opportunity (OEO) in 1965. The study focuses on the structure of the NHC system (funding agency, operating agency, and community board), analyzes the goals of the different sets of actors, and argues that the conflicts which evolved within the system were the natural outcome of the divergence in the goals of the different actors. Based on a series of 88 in-depth interviews with key health officials in OEO as well as project officers in NHCs throughout the country, the study suggests a framework for a more comprehensive analysis of the outcome of the NHC program and notes the implications of these findings for some current health legislation.