The Family Health Program in Brazil: from the conquests to the challenges

This article presents the results of a research which analyzedthe implementation of the Family Health Program (psf) inBrazil. The authors discuss the issue of access to primaryhealth care services within the fully publicly funded UnifiedNational Health Service (sus). psf implementation startedin 1994, as a strategic policy to reorganize the primary carein the municipal health systems. It involves the creationof multi-professional teams including community healthagents. This study was carried out in 12 municipalities thatwere pioneers in psf implantation, and which are located indifferent geographical regions. We used the Collective SubjectDiscourse technique and our analysis is grounded in theDialectic Hermeneutic Theory. We interviewed health servicemanagers on the federal, state and municipal levels, as wellas health professionals of the psf teams and patients. Accessremains seen from the perspective of disease. There are issuesrelated to funding, care coverage, sustainability, continuouseducation of professionals, a better definition on the roleplayed by members of psf teams, and integration of psf withother areas of the system (secondary and tertiary care). Weconclude that the psf is still a strategy that could potentialitydecrease health inequalities. It is necessary that health susmanagers and society realize that they can make of psf theorganizational base of primary health care; this would lead to the construction of a model of integral and family health careled by principles of solidarity, equality, and social justice.