Primary Health Care as “Decent Care”: A Normative Shift in the Delivery of Care

For too long, the business, economics, and bureaucracy of health have dominated the global and national discourses on health, health policy, and health care reform. For too long, health care has been abstracted to the systemic level. And for too long, humans have been displaced from the center – the heart – of health care processes. The time for real change and reform is woefully past due: it is imperative to reclaim the very humanity of health care and re-center health care around humans (patients, clients, etc.) and concrete human values. Currently, there are two movements in health care aimed specifically at recovering and repositioning humans at the center of health care and the design, development, implementation, and management of health care services. The first movement, primary health care (PHC), was initially introduced 30 years ago at a WHO conference and is now undergoing a much-needed global renaissance. The other movement, decent care, is a relatively new concept that has previously been explored in the limited contexts of HIV/AIDS and palliative care. To help recover the humanity of health care, it is important to link these two heretofore parallel movements in health care by showing: (a) how the values central to both PHC and decent care converge and intersect; (b) how the model of decent care provides a way to help implement PHC; and (c) how the adjoining of these concepts or movements represents a real way forward in designing, developing, and implementing human-centered models for organizing, delivering, and sustaining care services.