Mass produced village health workers and the promise of primary health care

The most evident aspect of primary health care (PHC) development in many countries is the mass recruitment and training of village health workers (VHWs). These VHW schemes are often merely an extension of the organized government health services. This paper takes the view that over emphasis of VHWs is a fatal limitation and narrowing of the original idea of PHC. In the spirit of PHC, communities should be allowed to go through the process of identifying their problems, sorting out their priorities, means of solving identified problems through the material and human resources they have at their disposal. Before communities have been allowed to go through such a process, the selection of VHWs is at best, an imposition from above. PHC is thus robbed of its most fundamental components, of community participation, self-determination and self-reliance.