Urban primary health care in Africa: A comparative analysis of city-wide public sector projects in Lusaka and Dar es Salaam

Roger Few, Trudy Harpham, Sarah Atkinson

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


Since the 1980s, a number of health system interventions in Sub-Saharan Africa have targeted urban areas, reflecting increasing attention to the contextual contrasts between urban and rural health settings. This article compares attempts in two projects-in Zambia and Tanzania-to strengthen urban primary health care in the public sector and make it more inclusive in a dual sense: making quality services more accessible to the poor; and fostering community involvement in health care and health-related activity. The paper reveals that the projects have produced many similar outcomes (both positive and negative), despite differences in their managerial arrangements. After identifying issues that may need to be considered in other health initiatives, the discussion revisits the urban/rural dimension of health care in relation to three key aspects: the by-passing of primary services, community participation and inter-sectoral action.
Original languageEnglish
Pages (from-to)45-53
Number of pages9
JournalHealth and Place
Issue number1
Publication statusPublished - Mar 2003


  • Consumer Participation
  • Great Britain
  • Health Services Accessibility
  • Humans
  • Poverty
  • Primary Health Care
  • Public Health Administration
  • Public Sector
  • Tanzania
  • Urban Health Services
  • Zambia

Cite this