GA Nnaji
Purpose: To review the concepts of Primary Health Care (PHC) and provide evidence for a shift in its focus and implementation in the resource poor setting.
Sources of data: Desk and internet based review of relevant articles and official documents.
Data extraction: Search themes were ‘concepts and models of PHC’, contextual issues in PHC and health care reforms aimed at achieving the universally accepted core social values of health care delivery.
Results: Four main concepts and approaches to PHC include selective PHC, primary care; Alma-Ata comprehensive PHC and health and human rights approach. The concept of PHC in resource poor settings is oversimplified and restrictive. This is in contrast with the situation in well-resourced contexts where primary care concept is practiced.The World Health Organisation recommends a shift in focus of PHC through four sets of reforms in the health system, universal coverage reforms, service delivery reforms, public policy reforms and leadership reforms. This shift should bridge the gap between citizens’ expectations and performance of the health care system.
Conclusion: Inability of health services to deliver levels of national coverage that meet stated demands and changing needs has been a source of worry. The health systems need to respond better and faster to the challenges of a changing world.