1 Section of Parasitology, Health and Development, Department of Veterinary Disease Biology, Faculty of Life Sciences, Københavns Universitet2 Research for Health Environment and Development3 Curriculum Comittee of the Master of International Health, Faculty of Health and Medical Sciences, Københavns Universitet4 Research for Equity and Community Health Trust5 University of Malawi6 World Health Organization7 Ministry of Health8 Curriculum Comittee of the Master of International Health, Faculty of Health and Medical Sciences, Københavns Universitet
Primary Health Care (PHC) is a strategy endorsed for attaining equitable access to basic health care including treatment and prevention of endemic diseases. Thirty four years later, its implementation remains sub-optimal in most Sub-Saharan African countries that access to health interventions is still a major challenge for a large proportion of the rural population. Community-directed treatment with ivermectin (CDTi) and community-directed interventions (CDI) are participatory approaches to strengthen health care at community level. Both approaches are based on values and principles associated with PHC. The CDI approach has successfully been used to improve the delivery of interventions in areas that have previously used CDTi. However, little is known about the added value of community participation in areas without prior experience with CDTi. This study aimed at assessing PHC in two rural Malawian districts without CDTi experience with a view to explore the relevance of the CDI approach. We examined health service providers' and beneficiaries' perceptions on existing PHC practices, and their perspectives on official priorities and strategies to strengthen PHC.