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Bridging the gap: The village health worker as the cornerstone of the primary health care model

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  • Bender, Deborah E.
  • Pitkin, Kathryn

Abstract

The Alma-Ata Conference in 1978 reiterated the goal of 'Health for All by the Year 2000' and declared primary health care (PHC) the vehicle through which this lofty goal was to be achieved. National governments were recognized as responsible agents for developing and implementing PHC plans. The emphasis on community-oriented delivery of care places great importance on the village health worker (VHW), the individual who serves as the 'interface' between the formal health care system and the community. Despite the acknowledged importance of the VHW role, the question of whether the PHC model, with the VHW as the cornerstone can be effectively implemented without a "fundamental shift of wealth and power" (Sidel) continues to be asked. This paper examines the evolution and current status of the VHW role in Costa Rica, Nicaragua and Colombia, three Latin American nations which have adopted the PHC model. The authors discuss the evolution of the PHC model in each country with particular reference to the occurence or non-occurence of fundamental changes in the society. The conclude that the primary determiner of successful implementation of PHC is a national commitment to PHC including recognition of the importance of community participation which is best achieved through reliance on the village health worker.

Suggested Citation

  • Bender, Deborah E. & Pitkin, Kathryn, 1987. "Bridging the gap: The village health worker as the cornerstone of the primary health care model," Social Science & Medicine, Elsevier, vol. 24(6), pages 515-528, January.
    • Handle: RePEc:eee:socmed:v:24:y:1987:i:6:p:515-528
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    Cited by:

    1. May, Marlynn L. & Contreras, Ricardo B., 2007. "Promotor(a)s, the organizations in which they work, and an emerging paradox: How organizational structure and scope impact promotor(a)s' work," Health Policy, Elsevier, vol. 82(2), pages 153-166, July.
    2. Riviere-Cinnamond, Ana, 2005. "Animal Health Policy and Practice: Scaling-up Community-based Animal Health Systems, Lessons from Human Health," PPLPI Working Papers 23775, Food and Agriculture Organization of the United Nations, Pro-Poor Livestock Policy Initiative.
    3. Purity Mwendwa, 2018. "What encourages community health workers to use mobile technologies for health interventions? Emerging lessons from rural Rwanda," Development Policy Review, Overseas Development Institute, vol. 36(1), pages 111-129, January.
    4. Standing, H. & Chowdhury, A. Mushtaque R., 2008. "Producing effective knowledge agents in a pluralistic environment: What future for community health workers?," Social Science & Medicine, Elsevier, vol. 66(10), pages 2096-2107, May.

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