Primary care from perspective of public health managers: qualitative study

Abstract

Primary Care refers to level of care that allows citizens to access the Brazilian National Health System (SUS) longitudinally and continuously. Proposal and operationalization of health management reaffirm social values, such as right to health. To qualitatively analyze perspectives related to this level of care, we interviewed managers from different hierarchical levels of Primary Care in a municipality of Mato Grosso. The data collected underwent a thematic Content Analysis, referenced by strategic thinking and planning in Public Health. Data concerning health management in Primary Care and the care provided to the population produced thematic nuclei involving rotational management, fragmented and emergency actions; opposition between humanization and technique; vertical health promotion. Managers showed commitment and search for the maintenance of services via assistance and specific actions. Top-down organization, which excludes user participation in planning, seems to have reinforced inconsistencies between the comprehensive proposal of Primary care and the daily structural unforeseen events, hindering the problematization necessary to transform the work processes. Institutionally strengthening the Primary Care network requires investment, permanent professional qualification, and active participation of subjects.