Professional Documents
Culture Documents
and
Selective Primary Health Care
Marcos Cueto
Universidad Peruana Cayetano Heredia
Mcueto@upch.edu.pe
Relevance
-Not studied from an historical perspective
-Vertical versus horizontal health interventions
-Implementation of health policies. Human resources
Outline
Background & Context
Actors, Institutions and Health Interventions
Impact & Legacies
Sources: Research at WHO & UNICEF archives.
Examples from Latin America
A medical team in the Wuchih Mountain area; one of them carries a board with a Mao
quotation "set the focus of medical care on the countryside. China Pictorial, November
1969 www.morningsun.org/ living/medicine/medicine.html
Medical Technology
Negative role of
Disease technology
In contrast: Appropriate technology,
scientifically sound, culturally acceptable
Elitism
Criticism to medical overspecialization
& top-down health campaigns
In contrast: Community participation. Work with traditional medicine
Development
PHC a new center of the public health system
An inter-sectorial approach to health
Part of a social and political movement for development
Post-Alma Ata:
Selective Primary Health Care
and new health interventions
Shortly after its appearance PHC was criticized for being
too broad, idealist and having an unrealistic timetable.
Conference Health and Population in Development
In 1979 at Bellagio, Italy. Rockefeller Foundation ,
The World Bank and USAID
Robert McNamara
Criticism to Selective PHC. David Werner and David Sanders. Questioning the
Solution. The Politics of Primary Health Care and Child Survival with an indepth critique of Oral Rehydratation Therapy. Palo Alto: Health Rights, 1997.
Finance
Implementation
A policeman
immunizes a
child during the
third
Colombian
National
Vaccination
day, summer
1984..
We are the
Children p. 179