Primary health care and the organization of regional health care networks in Brazil

Abstract

Even though there is a relative consensus regarding the utilization of the term "Primary Health Care", there are distinct conceptions concerning its effective meaning. This paper refers to numerous documents which have been expressing this concept historically and contributing to its organization in the health systems of the world. In this perspective, the following documents were considered: Dawson Report, the Declaration of Alma-Ata, the documents published by the European Observatory on Health Systems and Policies, which has analyzed reforms guided by Primary Health Care in European Union countries from 1990 onwards, the studies conducted by Barbara Starfield in relation to Primary Health Care in current times, and the World Health Report published by the WHO in 2008. The development of Primary Health Care in Brazil was also considered since the beginning of the 20th century until today, identifying the advances in its organization and recognizing that great hindrances must be overcome so that the purposes contained in the national policy are met, so that it can perform its role of organizer of the system and coordinator of health care. This study also analyzes the role of Primary Health Care in Regional Health Care Networks, which are organized within the SUS (Brazil's National Health System) in order to overcome the system's fragmentation, pointing to initiatives directed at its improvement.