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November 2002, Vol 92, No. 11 | American Journal of Public Health 1748-1755
© 2002 American Public Health Association

PUBLIC HEALTH MATTERS

Community-Oriented Primary Care: New Relevance in a Changing World

Fitzhugh Mullan, MD and Leon Epstein, MB, ChB, MPH

Fitzhugh Mullan is with the Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC. Leon Epstein is with the Department of Social Medicine, Hadassah Medical Organization and Hebrew University—Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.

Correspondence: Requests for reprints should be sent to Fitzhugh Mullan, MD, 7500 Old Georgetown Rd, Suite 600, Bethesda, MD 20814 (e-mail: fmullan{at}projecthope.org).

Since its inception in rural, pre-apartheid South Africa, community-oriented primary care (COPC) has intrigued and informed public health and primary care leaders worldwide. COPC has influenced such programs as the US community health center movement, the general practice movement in the United Kingdom, and recent reforms in the public health system of South Africa.

We provide a global overview of COPC, tracing its conceptual roots, reviewing its many manifestations, and exploring its future prospects as an organizational paradigm for the democratic organization of community health services. We examine the pitfalls and paradoxes of COPC and suggest its future utility.

COPC has important values and methods to offer disparate but powerful movements in public health worldwide.


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