PRIMARY HEALTH CARE: BRAZILIAN TRAJECTORY AND THE LOCAL CONTEXT IN PORTO ALEGRE

ABSTRACT

Primary Health Care (PHC) is considered internationally as a benefit to universal health systems. In Brazil, it is regulated by the National Primary Care Policy (PNAB) and in the last four years it has received significant reforms in its guidelines, changing the way in which this health care is implemented in municipalities. This article aims to analyze the trajectory of PHC policy in Brazil and understand the local context in the city of Porto Alegre/RS. Based on a qualitative and descriptive study, official documents on PHC (federal legislation and normative instruments) were analyzed. We also had as data source the Municipal Health Plan 2018-2021, the Annual Management Report 2020 and an interview with a municipal manager of the APS of Porto Alegre. In the national trajectory, recent reforms indicate an approach to the more selective PHC model, greater flexibility in partnerships with service providers and a reduction in community action. In Porto Alegre, there is a fragmentation of management between the Social Organizations of the hospital sector, following the national reforms and significantly changing the working design of the PHC.

Key Words:
Health policy; Decentralization; Primary Health Care