Magnussen, L., Ehiri, J., and Jolly, P. (2004). Comprehensive versus Selective Primary Health Care: Lessons For Global Health Policy (Links to an external site.). Health Affairs, 23(3):167-176. What is the main theme of this argument and what do you find surprising about the article?  

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This article looks at the movement that began in the 1970s in developing countries to provide healthcare for everyone. This model, which came out of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) at the International Conference on Primary Health Care in Alma Ata, Kazakhstan, in 1978, looked at health as more than just the absence of disease but as physical, mental, and social wellbeing. The plan was also to look at political, social, and economic causes of poor health and to examine how poverty and political instability affect health.

In retrospect, some scholars consider this initiative to have been a failure. Others acknowledge that while there were some successes in some countries such as Cuba, the model was never fully implemented. The article looks at the shortcomings of this selective primary health care model, including its unmet need to address the role of social justice and social equity in healthcare delivery. However, the model has had some successes, such as reducing infant mortality by 25% from 1980 to 1993. The authors recommend that healthcare practitioners work with local governments to improve health outcomes, that healthcare needs come from a grassroots approach, and that infrastructure in developing countries be improved. It is surprising that developing countries are still using a model that emphasizes disease eradication rather than promoting overall wellness in this day and age. 

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