Authoritarianism and Autonomy. 1. Conflicting Value Systems in the Introduction of Psychological Services in a South African Primary Health Care System

Abstract

Psychology functions within the context of South Africa's ruling ideology, resistance discourse and national health care philosophy. Using a psychological skills training programme in the Soweto Community Health Centre System in Johannesburg as a case study, the authors examine how the introduction of psychological services in primary health care is both enabled and constrained by state ideology, medical hegemony, professional interests and personal perceptions. Nuances underlying the subversion of an empowering concept such as primary health care, and some general rules about the perception of psychology that are likely to apply in South Africa and other developing countries, are discussed. In Part 2 (this issue) this etic perspective is extended into an emic exploration of how these factors impact upon the interpersonal processes and practices of nursing staff in the health care system.