Health-Policy Innovation and International Assistance in Central Africa
For over a decade, international health activities have emphasized primary health care (PHC) as a priority policy for health care delivery in the Third World. During the 1970s, a general consensus onthe central goals and activities of this policy emerged in international health meetings. ' PHC, a policy model designed to provide relatively low-cost services first in underserved rural areas and then in marginal urban areas, involves training auxiliary health workers and village volunteers to promote preventive health activities related to sanitation, water purification, nutrition, and maternal and child health. These health workers and volunteers learn to perform simple curative procedures and to identify cases for referral to more skilled health professionals. The PHC model also encourages communities to participate actively in the selection of those to be trained, the establishment of local health priorities, and the provision of volunteer labor and donated local materials. In addition to this core of activities, broader social and economic changes are also deemed necessary to achieve health goals. Yet specific program activity for promoting these changes has not been as universally accepted by health experts as the model just described.