A trajetória da política nacional de atenção básica no Sistema Único de Saúde: uma revisão integrativa

Abstract

The present work is about the state of the art of the National Primary Care Policy. Its objective was to analyze its trajectory in the Brazilian public health system, based on the changes that occurred with a view to neoliberal ideals. The research was carried out between March and April 2021, in the Virtual Health Library, with filtering in the Latin American and Caribbean Literature in Health Sciences and Scientific Electronic Library Online databases. The data search exposed 389 publications in the Latin American and Caribbean Literature in Health Sciences database and 96 in the Scientific Electronic Library Online, representing a total of 485 productions. However, during the search in the databases, duplicated works were found, configuring a total of 146 repeated productions. Therefore, 339 productions served as the object of analysis at this first moment, moving on to the next stage, with the application of the other exclusion criteria. In the end, 35 articles remained as the data source for this study. The legal frameworks presented were a starting point and dialogued with the theoretical frameworks found: advances and challenges of Primary Health Care in the Unified Health System, possible impacts of the new financing of Primary Health Care, primary care in the Unified Health System, the National Policy for Primary Care 2006 and 2011 and the development of the Family Health Strategy, criticisms and reformulations of the National Policy for Primary Care 2017, Primary Care: from its radicalism to the National Policy for Primary Care 2017, “Bridge to the Future”, “ Social Crossing, 1988 Constitution and SUS and the segmentation of care: essential and expanded standards of services. Throughout the entire work, it is possible to observe that the National Policy for Primary Care, despite the first and second versions showing an appreciation of Primary Health Care, we feel that throughout the productions, the third edition showed a certain devaluation of the Family Health Strategy , being an important strategy for bringing health professionals closer to users. The research showed that the latest version of the National Primary Care Policy no longer prioritizes the Family Health Strategy, as we observed in other versions published in 2006 and 2011, in addition to the weaknesses presented as the flexibility of the doctors' workload, a decrease in the amount of Community Health Agents per Family Health Team and alteration of funding, since now the actions of the Family Health Strategy are only guaranteed by registered users.