There are two main approaches to primary health care: selective and comprehensive. The selective approach focuses on specific health problems, targets, and priorities as chosen by health professionals in a top-down manner. It is argued to be cheaper and easier to implement but does not emphasize community participation. The comprehensive approach, based on the principles of Alma-Ata, considers all determinants of health, stresses people's participation, and collaborates across sectors to address issues of social justice, equality, and equity. Policy decisions on which approach to take can significantly impact the quality of life for many people.

1. SELECTIVE AND COMPREHENSIVE PHC
• These are the two types of PHC
• most important debates have been going on about the
best PHC; selective or comprehensive approach
• these approaches lead to crucial policy decisions
• The policy decisions made on this matter affects the
quality of life of many people

2. SELECTIVE APPROACH
• involves selection of the health problem
• Selection of the target
• The target can be the priority target or the most
affected
• The problem may also be the priority
problem or need
• selective primary health care is said to
be a medical model

3. • Policies in the selective approach are implemented by
health professionals
• It does not emphasises on participatory
approaches.
• Selective PHC has been called weak PHC
• top down in approach, people or community
members may participate at a low level

4. ADVANTAGES
• Advocates of selective PHC say that it the
cheaper
• Less demanding because it looks at
specific.
• Health workers select the target for
intervention
• Health intervention is only aimed at those
conditions of ill health which are most
which are of priority

5. • It is easy to manage and monitor as you
focus only on a few health problems
which can be directly assessed and
evaluated.
• It is cheap as resources can be used
only on those pressing health needs
With the limited number of health
workers, it easy run programmes

6. COMPREHENSIVE PRIMARY HEALTH CARE
• Comprehensive PHC is seen as a strong PHC.
• It involves all determinants of health
• The approach which was presented by the Alma
Ata is the strong PHC
• Comprehensive primary Health Care is the real
PHC.
• the approach is concerned with health for all

7. • health as part of development which can not be
isolated
• Comprehensive PHC collaborates with other
sectors
• stresses people’s participation in the search for
solutions as essential components of PHC
• Comprehensive PHC insists on the involvement
of other sectors

8. • It is the duty of the health worker to collaborate
with other sectors
• Comprehensive PHC can be operationalized
along the social and economic development
• Comprehensive PHC gives considerable
importance to people’s involvement in health
• It embraces community participation as the key
principle of PHC.

9. • It is concerned with issues to do with social
justice, equality and equity.