Primary Health Care in the SUS: the inseparability of care, management and education

Abstract

Since the Alma Ata Conference in 1978, Primary Health Care (PHC) has been a topic of discussion among academics, managers, and health professionals. The Astana Global Conference addressed this issue in 2018, and disagreements continue to exist. Since the mid-1990s, Family Health Strategy (ESF in Portuguese) has been a priority in the reorganization of PHC in Brazil. It complies with the SUS (Unified Health System) tenets and is driven by a broad understanding of the processes underlying health and disease, valuing intersectoral efforts and assembling multidisciplinary teams with strong links to territories, communities, and families. It depicts a healthcare model that requires skills that go beyond what is typically learned in technical training programs or upon graduation. Since the 1990s, efforts have been made to promote better qualifications to reduce barriers to education and to offer "continuing training" to professionals working in the SUS. This is a crucial component of transforming the healthcare model. The growth of educational programs and initiatives aimed at acting in PHC has facilitated processes of enhancing the knowledge and learning on the subject of changes in healthcare practices, organization, and management in SUS. The Covid-19 pandemic sparked the escalation of socioeconomic injustices and raised the risk of poor health indicators, creating new demands for PHC. This article discusses the new PHC imperatives and emphasizes the need to improve public health systems by addressing structural issues, implementing comprehensive policies, and making investments that ensure that everyone has access to healthcare.