UBC Theses and Dissertations
An analysis of evaluative research : the case of primary health care Chauvin, James Brodie
The primary health care (PHC) model is being actively promoted as an effective and lower-cost alternative to conventional health care delivery systems in many developing countries. Despite the fact that over 300 PHC projects of varying scale have been implemented and reported on throughout the Third World over the past two decades, there appears to be little evidence available to support the popular hypothesis that the availability and utilization of primary health care services necessarily results in significant improvements in health. The objective of this thesis is to identify alternative strategies for evaluating PHC projects which will establish credible and useful results. The thesis reviews the evolution of both the PHC model and evaluative research methodologies, and then presents a critical analysis of a set of PHC project evaluations. The aim of this exercise is to identify some of the major factors which have limited the validity, utility and significance of the evaluation results. The thesis suggests that less rigorous evaluative research designs and evaluative techniques which use a combination of quantitative and qualitative data be used to enhance the credibility and utility of evaluation results.