Health Affairs

Health Affairs, 23, no. 3 (2004): 167-176 doi: 10.1377/hlthaff.23.3.167 © 2004 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Comprehensive Versus Selective Primary Health Care: Lessons For Global Health Policy

Lesley Magnussen, John Ehiri and Pauline Jolly

Primary health care was declared the model for global health policy at a 1978 meeting of health ministers and experts from around the world. Primary health care requires a change in socioeconomic status, distribution of resources, a focus on health system development, and emphasis on basic health services. Considered too idealistic and expensive, it was replaced with a disease-focused, selective model. After several years of investment in vertical interventions, preventable diseases remain a major challenge for developing countries. The selective model has not responded adequately to the interrelationship between health and socioeconomic development, and a rethinking of global health policy is urgently needed.

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