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Why health improves: Defining the issues concerning 'comprehensive primary health care' and 'selective primary health care'

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  • Rifkin, Susan B.
  • Walt, Gill

Abstract

What is the impact of technology on improving the life situations of people, especially the poor? How is this impact analyzed in terms of health improvements? These questions are paramount in the minds of health planners as they pursue national policies of primary health care, a policy popularized by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) and accepted by over 150 governments at Alma Ata in 1978. The purpose of this paper is to explore these questions in depth. It begins by giving the background to the debate, then examines the origins of two concepts which have dominated the field, those of 'primary health care' and 'selective primary health care.' On this basis it suggests areas of differences in the two concepts and discusses the policy and practical implications of confusing the two approaches. The paper suggests that the differences are firstly who controls the outcome of technological interventions and the perceived time frame in which plans can be carried out.

Suggested Citation

  • Rifkin, Susan B. & Walt, Gill, 1986. "Why health improves: Defining the issues concerning 'comprehensive primary health care' and 'selective primary health care'," Social Science & Medicine, Elsevier, vol. 23(6), pages 559-566, January.
    • Handle: RePEc:eee:socmed:v:23:y:1986:i:6:p:559-566
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    Citations

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    Cited by:

    1. Murray, Christopher J. L., 1995. "Towards an analytical approach to health sector reform," Health Policy, Elsevier, vol. 32(1-3), pages 93-109.
    2. Lewis, Maureen & Eskeland, Gunnar & Traa-Valerezo, Ximena, 2004. "Primary health care in practice: is it effective?," Health Policy, Elsevier, vol. 70(3), pages 303-325, December.
    3. Brown, Malcolm C. & Crampton, Peter, 1997. "New Zealand policy strategies concerning the funding of general practitioner care," Health Policy, Elsevier, vol. 41(2), pages 87-104, August.
    4. Valeria Oliveira-Cruz & Christoph Kurowski & Anne Mills, 2003. "Delivery of priority health services: searching for synergies within the vertical versus horizontal debate," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 67-86.
    5. Kitamura, Tomomi & Obara, Hiromi & Takashima, Yoshihiro & Takahashi, Kenzo & Inaoka, Kimiko & Nagai, Mari & Endo, Hiroyoshi & Jimba, Masamine & Sugiura, Yasuo, 2013. "World Health Assembly Agendas and trends of international health issues for the last 43 years: Analysis of World Health Assembly Agendas between 1970 and 2012," Health Policy, Elsevier, vol. 110(2), pages 198-206.
    6. Flessa, Steffen, 2003. "Priorities and allocation of health care resources in developing countries: A case-study from the Mtwara region, Tanzania," European Journal of Operational Research, Elsevier, vol. 150(1), pages 67-80, October.
    7. Christopher Barrett & Joanne Csete, 1994. "Conceptualizing hunger in contemporary African policymaking: From technical to community-based approaches," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 11(4), pages 38-46, September.
    8. Stekelenburg, Jelle & Kyanamina, Sindele Simasiku & Wolffers, Ivan, 2003. "Poor performance of community health workers in Kalabo District, Zambia," Health Policy, Elsevier, vol. 65(2), pages 109-118, August.
    9. Riviere-Cinnamond, Ana, 2005. "Animal Health Policy and Practice: Scaling-up Community-based Animal Health Systems, Lessons from Human Health," PPLPI Working Papers 23775, Food and Agriculture Organization of the United Nations, Pro-Poor Livestock Policy Initiative.
    10. Lewis, Maureen & Eskeland, Gunnar S. & Traa-Valerezo, Ximena, 1999. "Challenging El Salvador's rural health care strategy," Policy Research Working Paper Series 2164, The World Bank.
    11. Pauline Murray‐Parahi & Michelle DiGiacomo & Debra Jackson & Patricia M Davidson, 2016. "New graduate registered nurse transition into primary health care roles: an integrative literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(21-22), pages 3084-3101, November.

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