%0 Journal Article
%T A pol¨ªtica federal de aten  o b¨¢sica ¨¤ sa¨²de no Brasil nos anos 2000 The federal primary health care politics in Brazil in the 2000's
%A Ana Luisa Barros de Castro
%A Cristiani Vieira Machado
%J Physis: Revista de Sa¨²de Coletiva
%D 2012
%I Instituto de Medicina Social da UERJ
%R 10.1590/s0103-73312012000200005
%X Este artigo analisa a condu  o federal da pol¨ªtica de aten  o b¨¢sica ¨¤ sa¨²de no Brasil nos anos 2000, buscando identificar elementos de continuidade e mudan a com rela  o ao per¨ªodo anterior. A pesquisa se baseou no marco te¨®rico do institucionalismo hist¨®rico e no conceito de path-dependence. A metodologia compreendeu uma diversidade de estrat¨¦gias: revis o bibliogr¨¢fica; an¨¢lise documental; an¨¢lise de bases de dados secund¨¢rios; an¨¢lise or ament¨¢ria e realiza  o de entrevistas com atores-chave da pol¨ªtica. Foi poss¨ªvel identificar continuidades e mudan as na condu  o federal da pol¨ªtica nacional de aten  o b¨¢sica no per¨ªodo estudado. A predominancia de continuidades, ressaltando-se a persist¨ºncia do Programa de Sa¨²de da Fam¨ªlia como estrat¨¦gia hegem nica para a reorienta  o da aten  o b¨¢sica no pa¨ªs, configura uma situa  o de path-dependence. Observaram-se tamb¨¦m mudan as incrementais, a exemplo de iniciativas de fortalecimento da articula  o intersetorial e inova  es importantes, com destaque para a cria  o dos N¨²cleos de Apoio ¨¤ Sa¨²de da Fam¨ªlia. Persistem, no entanto, problemas estruturais no ambito da aten  o b¨¢sica, cuja supera  o ¨¦ importante para viabilizar a efetiva mudan a do modelo de aten  o ¨¤ sa¨²de no pa¨ªs. This paper analyzes the conduct of the federal primary health care politics in Brazil in the 2000's, seeking to identify elements of continuity and change in the previous period. The research was based on the theoretical framework of historical institutionalism and the concept of path dependence. The methodology included a variety of strategies: literature review, document analysis, analysis of secondary databases, budget analysis and interviews with key stakeholders of the policy. It was possible to identify continuities and changes in the conduct of national policy for federal primary care during the study period. The predominance of continuities, emphasizing the persistence of the Family Health Program as a hegemonic strategy for reorientation of primary care in the country, creates a condition of path-dependence. There were also incremental changes, such as initiatives to strengthen inter-sectoral coordination and important innovations, notably the creation of the Centers for Family Health Support. There are, however, structural problems within primary care, and it is important to overcome them to enable the effective change in the health care model in the country.
%K aten  o b¨¢sica ¨¤ sa¨²de
%K pol¨ªtica de sa¨²de
%K Programa de Sa¨²de da Fam¨ªlia
%K primary health care
%K health politics
%K Family Health Program
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-73312012000200005