Primary care and reform of health systems: A framework for the analysis of latin american experiences

Julio Frenk, Miguel A. González-Block

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


The article first proposes a framework within which to assess the potential of health sector reforms in Latin America for primary health care (PHC). Two dimensions are recognized: the scope of the reforms, content, and the means of participation that are put into play. This framework is then complemented through a critique of the often-sought but little-analyzed PHC reform strategies of decentralization and health sector integration. The analytical framework is next directed to the financing of health services, a chief aspect of any reform aiming toward PHC. Two facets of health service finance are first distinguished: its formal aspect as a means for economic subsistence and growth, and its substantive aspect as a means to promote the rational use of services and thus improvement of health. Once finance is understood in this microeconomic perspective, the focus shifts to the analysis of health care reforms at the macro, health policy level. The article concludes by positing that PHC is in essence a new health care paradigm, oriented by the values of universality, redistribution, integration, plurality, quality, and efficiency.

Original languageEnglish (US)
Pages (from-to)32-43
Number of pages12
JournalHealth Services Management Research
Issue number1
StatePublished - Mar 1992
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy


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