The origins of primary health care and selective primary health care

Abstract

I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations' political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America.

Figure 1

Halfdan T. Mahler, director general of the World Health Organization, 1973–1988. Source. Prints and Photographs Collection, History of Medicine Division, National Library of Medicine, Bethesda, Md.

Figure 2

Oral rehydration salts promoted by selective primary health care were criticized in this drawing as a “Band-Aid.” (Drawing by Alicia Brelsford, reprinted with permission from David Werner. David Werner and David Sanders, with Jason Weston, Steve Babb, and Bill Rodriguez, Questioning the Solution: the Politics of Primary Health Care and Child Survival, with an In-Depth Critique of Oral Rehydration Therapy [Palo Alto, CA : HealthWrights, 1997].)