Public participation and community engagement in health care services is a critical aspect of the PHC model. The Alma Ata Declaration defines PHC as essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community. This, through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.

It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process.

According to the National Health Act (2003) Government, health care workers and the public all have a role to play in strengthening health systems in South Africa:

• The Minister of Health, within the limits of available resources, has to protect, promote, improve and maintain the health of the population providing essential health services;
• The public health sector provides free health services to pregnant and lactating women and children below the age of six years, who are not members of medical aid schemes;
• The duties of the public include adhering to the rules of the health establishment, providing accurate information, and treating health care workers with respect and dignity;
• The rights of the public include the right to participate in decisions affecting their health, undergoing an informed consent process, and the right to refuse treatment

“everyone has the right to have access to health care services, including reproductive health care; sufficient food and water; and social security and the state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of each of these rights” South African Bill of Rights, Section 27