## Selective Primary Health Care (SPHC) — Walsh & Warren Model **Key Point:** Selective Primary Health Care is a pragmatic, resource-constrained approach that prioritizes high-impact, cost-effective interventions for the most significant health problems in a population. ### Concept of Selective PHC **High-Yield:** SPHC emerged in the 1980s as a response to resource limitations in developing countries. Rather than attempting comprehensive PHC (which requires substantial investment), SPHC focuses on: 1. **Identification of major health problems** — disease burden, mortality, morbidity 2. **Selection of cost-effective interventions** — proven impact per unit cost 3. **Targeted delivery** — to populations with greatest need 4. **Measurable outcomes** — focus on reducing mortality and morbidity ### Examples of SPHC Interventions | Intervention | Target Problem | Impact | | --- | --- | --- | | Oral Rehydration Therapy (ORT) | Diarrheal dehydration | Reduces child mortality | | Immunization programs | Vaccine-preventable diseases | Cost-effective disease prevention | | Antenatal care + safe delivery | Maternal mortality | Reduces MMR significantly | | Malaria control (bed nets, ACT) | Malaria burden | High ROI in endemic areas | | Tuberculosis DOTS | TB transmission | Cost-effective case detection | **Warning:** SPHC is NOT the same as **Comprehensive PHC**. Comprehensive PHC aims to provide all health services; SPHC is selective and prioritized due to resource constraints. **Clinical Pearl:** India's NRHM (now NHM) incorporates SPHC principles by targeting high-burden diseases (TB, malaria, maternal health) while building toward comprehensive coverage.
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.