Paper short abstract:

I would analyze the anthropological implications of thinking about Primary Health Care as a patient-centered care domain, focusing on the role of the Community Health Worker. The foucaultian concepts of subjectification, governamentality and care of the self will be the main analytical instruments.

Paper long abstract:

The paper wants to propose an anthropological and critical analysis of the Primary Health Care (PHC) programs and practices, trying to bring into light the relations between the specific rationality and the tactics used for their implementation.

The central idea of the PHC programs is making the patient able to constantly check and monitor his own health conditions, and thus to reach the competence and instruments necessary to understand how to prevent illness. This is the so-called patient-centered care domain.

I will refer to my fieldwork research in Brazil on the role of the Community Health Worker (CHW), an important figure of the Family Health Program, the brazilian version of PHC.

Using the foucaultian concepts of subjectivation and governamentality, the paper will try to present the brazilian CHW as a subject who is supposed that act on the actions of governed citizens, in order to empower individuals regarding their health conditions. The CWH teaches his patients how to achieve a specific "care of the self", which is aimed at forming their capacity to invest on their own health, expecting a return in the future ("preventive approach").

What are the implications of this way of thinking about health? How can we analyse, in an anthropological perspective, the transition from a curative-based medicine to a preventive medicine, grounded over the family behaviours?