Course: Case Studies in Primary Health Care

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Course Description

This course introduces students to the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries. As in clinical bedside teaching, we use real cases to help students develop problem-solving skills in practical situations. We also discuss participatory approaches in the organization and management of health services and other factors such as equity, socio-cultural change, environmental protection, and the process of community empowerment.

Overall Aims

  • To facilitate students' ability to understand participatory methods in building community capacity to solve priority problems in varied health care settings
  • To build on students' prior experiences and help them develop skills in learning how to use case studies in their own work and teaching
  • To facilitate students' ability to scale up community based successes from a local situation to general extension
  • To help students clarify their own values and attitudes in developing partnership relationships with communities and colleagues


This course is designed for students who expect to promote and participate in community-based programs. It is not appropriate for those whose interests are in basic research dealing with numbers rather than people.

The lectures will follow a textbook on community-based primary health care. Most lectures will focus on a case study or important concepts of community-based primary health care. For most case studies, there is additional background documentation available on the course Web site.

Course Objectives

  • To learn practical methods of promoting participatory activities in communities and action groups
  • To critically examine the conditions and practical techniques for developing partnerships to improve: bottom-up participation of communities, top-down support by officials, and outside-in stimulation by change agents
  • To explore in depth concepts of equity, justice, sustainability, scaling up, the tilting point in community empowerment and challenges in promoting changes in behaviors and social norms
  • To analyze strategies of multi-sectoral collaboration and integration within health services
  • To critically identify successes and failures or weaknesses of each case study and lessons learned from these
  • To understand the key concepts of the SEED-SCALE paradigm for implementing community-based primary health care


The required textbook for the course is: Taylor-Ide, D & Taylor, C.E. (2002). Just and lasting change: When communities own their futures. Baltimore: Johns Hopkins University Press.

A recommended textbook for the course is: Arole, M. & Arole, R. (1994). Jamkhed: A Comprehensive Rural Health Project. London: The MacMillan Press

Course Requirements

Course evaluationis based on three methods of judging student understanding of the cases and concepts:

  • Completing a 10-page paper (60 points)
  • Listening to the lectures and participating in LiveTalk sessions (20 points)
  • Participating in bulletin board discussions (20 points): at least one posting per week consistent with the Lecture Guide questions which can be viewed from the respective lecture pages.