Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480, Manguinhos. Rio de Janeiro RJ Brasil.
Faculdade de Medicina, Universidade Federal do Rio de Janeiro. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2020 Mar;25(4):1475-1482. doi: 10.1590/1413-81232020254.01842020. Epub 2020 Jan 17.
This paper analyzes recent policies in the field of Primary Health Care (PHC) and their possible implications for the care model in the Unified Health System (SUS). Initially, some of the concepts that influenced the models of care in the Brazilian public system are revived, and we argue that the Family Health Strategy (ESF) bases for reorienting care practices in primary care are consistent with the principles of the SUS. Below, we analyze the central elements of new federal policies for PHC. We show that changes in the PHC care model threaten the teams' multidisciplinarity, prioritize acute illness care, focus in individual care, weaken the community territorial approach and establish coverage by registration, which evidence redirection of the health policy, harming the principles of universality, integrality, and equity in the SUS.
本文分析了初级卫生保健（PHC）领域的近期政策及其对统一卫生系统（SUS）中护理模式的可能影响。最初，一些影响巴西公共系统护理模式的概念得以恢复，我们认为，家庭健康战略（ESF）为重新调整初级保健实践提供了基础，这与 SUS 的原则是一致的。下文分析了新的联邦 PHC 政策的核心要素。我们表明，PHC 护理模式的变化威胁到团队的多学科性，优先考虑急性疾病护理，关注个体护理，削弱社区的地域方法，并通过注册建立覆盖范围，这表明卫生政策发生了转向，损害了 SUS 的普遍性、完整性和公平性原则。
