BACKGROUND:
The 1978 Alma-Ata Declaration is often framed as the origin of comprehensive primary health care (PHC). However, decades earlier, Sidney and Emily Kark developed Community-Oriented Primary Care (COPC) in South Africa, operationalizing core PHC principles such as community diagnosis, integration of epidemiology and care, and active community participation. Despite its relevance, COPC remains under-recognized in dominant historical narratives.

METHODS:
This study presents a historical and comparative analysis of primary health care development, structured through a synthesized chronological timeline that integrates global milestones with the Brazilian experience. The analysis draws on archival sources, peer-reviewed literature, policy documents, and findings from Monique Alves Padilha’s doctoral thesis on community-oriented primary care and the Family Health Strategy (ESF).

RESULTS:
The reconstructed timeline demonstrates that COPC preceded Alma-Ata and provided a concrete, operational model for comprehensive PHC. Its principles re-emerge in later global frameworks but are often disconnected from their origins. In Brazil, these concepts intersect with the trajectory of SUS and ESF, revealing persistent tensions between selective and comprehensive approaches, while highlighting the strategic role of community participation and territorial action.

CONCLUSIONS:
Re-centering COPC within the historical timeline of PHC strengthens conceptual clarity, supports decolonial perspectives in public health, and offers practical insights for contemporary health system reform. Recognizing community participation as a foundational technology—rather than a complementary strategy—remains essential for equity-oriented and resilient health systems. Figure. Historical timeline of Community-Oriented Primary Care and Primary Health Care development (1910–2020)