Organization and Management of Health Systems and Services
Division of Health Systems and Services Development

Primary Health Care in the Americas: Conceptual Framework, Experiences, Challenges and Perspectives

August 2002

Primary Health Care in the Americas: Conceptual Framework, Experiences, Challenges and Perspectives

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Practitioners, educators, and researchers continue to search for innovative strategies and solutions to address priority areas that are relevant to societal and community needs. In this document for practitioners, researchers, and educators, we present a review of literature reflecting the models of care used for practice, research and education in the Region of the Americas.

We begin the review with a broad, inclusive notion of health. In this sense, health is considered more than the absence of disease. Further, we recognize that over-arching determinants of preventable illness and death are often the result of poverty, unemployment, and lack of participatory development, not biological/physiological determinants (Gottschalk, 1999). Moreover, policies devoid of the values embedded in society as well as consideration of the impact of social and economic policies (McKnight, 1995) can negatively affect health status on an individual and community level.

To gain an understanding of the sociopolitical and economic realities as well as the goals of a community and society, providers of health care services must familiarize themselves with the concepts that relate to growth, development, and sustainability (Gottschalk, 1999). How these concepts are defined and operationalized are critical factors for providers attempting to meet the health needs of communities and particularly members considered vulnerable. Specifically, providers need to incorporate a broad understanding of the interconnectedness of these concepts into their daily practice.

We present a Primary Health Care (PHC) Model that can be used as a philosophy and a strategy to promote health and to prevent diseases, through comprehensive health care, that is collaboratively and cooperatively provided by community members and multiple, health relevant disciplines. Additionally, the literature is reviewed to discuss and to examine the types of health care providers, the mode of service delivery, the location of services, types of health care programs, and health concerns/issues. We also discuss measurement criteria issues, evaluation methods, and implications, challenges, and perspectives. This document will be useful as a guide for practitioners, educators, and researchers who are interested in health issues and are involved in decision-making and policy development for institutions and programs providing health care services. Many practitioners, educators, and researchers assume that their practice-base is theoretical. We hope to challenge that idea with the suggestion that the PHC perspective is a useful way to organize disparate literature, take stock, and determine a preferred future.