PRIMARY HEALTH CARE, SELECTIVE OR COMPREHENSIVE, WHICH WAY TO GO?

Abstract

ABSTRACT
Objective: To critically review the advantages and disadvantages of selective versus
comprehensive Primary Health Care(PHC) approaches as a strategy towards improving
health in the developing world.
Data sources: Review of literature on PHC.
Data selection: Relevant papers from western and developing world literature.
Data extraction: Search of Pub-med, WHO/UNICEF reports, and relevant publications on
PHC.
Data synthesis: Examination of principles behind PHC and practical experiences in PHC
in the developing world.
Conclusions: Selective PHC programs have improved specific aspects of health, frequently
at the expense of other health sectors, but fail to address an individual’s health in holistic
manner, or the health infrastructure of countries. Selective PHC programs tend to focus
only on a small subset of the community. Comprehensive PHC is expensive to implement,
however addresses health of individuals more holistically, addresses both preventive and
curative health care, and promotes health infrastructure development and community
involvement, thereby providing more sustainable improvement of health in the whole
community.