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Aim: The article highlights the value of a strategic approach for the development of a primary care health centre.Methods: The method is adapted from corporate strategy: (i) analysis of the situation of the health centre and the obstacles to its development. (ii) selection of relations on which the strategy can be developed. (iii) elaboration of a system of interventions to create a cumulative development process. (iv) Illustration of the method by application to a case.Results: The example illustrates the principles and method and highlights the importance of interpretations and choices in elaboration of a strategy, which is therefore always a unique construction.Conclusion: The strategic approach provides a framework that (i) provides a subject of discussion and negotiation between members of the health centre, (ii) strengthens the consistency of structural decisions, (iii) helps the health centre to overcome obstacles and initiate a development process.