Primary health care: Why has water been neglected?

May Yacoob, William Brieger, Susan Watts

Research output: Contribution to journalArticlepeer-review


Since primary health care became 'selective' the need for clean water sources has largely been neglected. This paper highlights both the economic and philosophical necessity to look again at the approach to primary health care. An observational study from Nigeria is used to exemplify a community where a clean water source was the most urgent need, yet was ignored. Guinea worm infestation therefore caused serious disability in the community and resulted in a reduced uptake of the very forms of 'selective' primary health care that have been favoured internationally - breastfeeding, immunizations, malaria treatment and oral rehydration therapy. In particular, the effect of such disability on women - who have prime responsibility for the health and welfare of their families - was seriously underestimated, to the detriment of child health and survival. A clean, convenient water supply should be an essential component of primary health.

Original languageEnglish (US)
Pages (from-to)328-333
Number of pages6
JournalHealth policy and planning
Issue number4
StatePublished - Dec 1 1989
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy


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