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November 2002, Vol 92, No. 11 | American Journal of Public Health 1725-1728
© 2002 American Public Health Association

COMMUNITY-ORIENTED PRIMARY CARE

Roots, Shoots, but Too Little Fruit: Assessing the Contribution of COPC in South Africa

Stephen M. Tollman, MMed, MPH, MA and William M. Pick, FFCH, MMed

The authors are with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

Correspondence: Requests for reprints should be sent to Stephen M. Tollman, MMed, MPH, MA, Health and Population Division, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, 2193 Johannesburg, South Africa (e-mail: tollmansm{at}sph.wits.ac.za).

Community-oriented primary care (COPC) originated in South Africa during the 1940s and 1950s, where it served to inform local church-based and nongovernmental organization–based initiatives during the apartheid years. During the 1990s, COPC played an inspirational role in the process of national health policy formulation.

Yet COPC’s contribution to current health practice remains more symbolic than substantive. Despite a policy framework that favors the widespread introduction of COPC, various political, structural, managerial, and human resource obstacles constrain its effective implementation.

Notwithstanding a rapidly changing health care environment and well-established health transition from infections and nutritional disorders to non-communicable diseases and injury, COPC and its variants remain abidingly relevant to South Africa’s—and Africa’s—health care reality. (Am J Public Health. 2002;92:1725–1728)




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