Implementation of primary health care - package or process?
After establishing the commitment of the government to comprehensive primary health care (PHC), the Department of Health and provinces are now faced with the challenge of implementation. An important response has come with the recent proposed'core package of primary health care services'.' After consultation with national, provincial, district and facility health managers, various 'core packages' of services to be delivered at community, clinic/mobile and community health centre levels have been proposed. For example, undernutrition, which affects more than 1 in 4 young South African children,' is to be dealt with through treatment protocols, clinic-based growth monitoring and marketing messages about breastfeeding. The core package initiative seems to offer a pragmatic approach with its outlines of tasks and timetables and has been justified as a 'planning tool to move towards comprehensive services'.' In contrast, we believe there is a danger that it may have the opposite effect.