Primary health care for whom? Village perspectives from Nepal

Primary Health Care and Medical Pluralism Exemplified in Nepal: A Proposal for Maximizing Health Care Benefit

“…According to Stone (1986), in Nepal and other developing countries, PHC is caught in a contradiction. For while the term local/community participation specifies that communities should be able to define their own health requirements and mobilize local resources for solutions to the perceived health needs, as a formal plan PHC has already defined people's needs and strategies for meeting them.…”

“…The health status is further affected by the widespread preva lence of infectious diseases related to poor sanitation and water supply, and malnutri tion (World Bank 1983). PHC services, thus, places special emphasis on family plan ning, specific disease detection and control, maternal and child health, and general health and nutrition programs (Stone 1986). …”

“…Several researchers (e.g., Taylor 1976;Good et al 1979;Oswald 1983;Stone 1986) have stressed the fact that to improve PHC goals they should be adapted to local socio-cultural conditions and health care needs, and that PHC has to function with the indigenous health systems in order to ensure widespread acceptance and ulitization. The ways and means by which this can be achieved are, however, not clear and a number of approaches have been suggested.…”

Community participation and community‐based rehabilitation: An Indonesian case study

“…Perhaps the most important benefit is the heightened sense of responsibility and conscientiousness regarding health that is developed, and a concomitant gain of new skills and control over health resources. A related benefit is the potential for greater diffusion of health knowledge in the com munity and a greater use of indigenous expertise (Stone, 1986;Woelk, 1992). The organisation and delivery of health services are also reported to benefit greatly from community participation.…”

“…Numerous authors within the context of PHC have argued that without indigenous expertise projects will not be sustainable (Nichter, 1984;Stone, 1992;Woelk, 1992). Unfortunately, as Stone (1986) has stated, PHC has adopted a negative view of indigenous health traditions as largely 'superstition' and characterised local people as 'ignorant'. She sug gests that PHC initiators stop viewing indigenous health concepts as scientifi cally 'right' or 'wrong' and examine ways of linking modern health messages in ways that would increase the relevance of these messages to the people.…”