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LEARNING FROM THE COMMUNITY: IMPLICATIONS OF A NEW APPROACH TO PUBLIC HEALTH FOR MEDICAL EDUCATION *

The question of relevance is emerging as a growing challenge to medical education and practice. Basic to the discussion of relevance are people's own perceptions of needs and their daily choices related to health and disease. Public health should be less prescriptive and more based on the concept of ‘optimal choice’ specific to the challenges of each context and informed by community needs and perceptions, technological advances, available resources and basic values of equity and social justice. Communities and their active participation in decision‐making and action for health should be understood to represent the core of the health system, and all other elements be tested as to how relevant they are in enabling communities and people to make the best choices for health and in giving them necessary assistance in the protection against disease. It is an urgent need for conceptualization and operationalization of a public health that can bridge current gaps, integrate the required disciplines and define linkages between the various partners and levels in the system.