The practice of physicians and nurses in the Brazilian Family Health Programme – evidences of change in the delivery health care model

A questionnaire was used to assess the evidences of assimilation of the new values and care principles proposed by the programme.The results showed that a great number of professionals seem to have incorporated the practice of home visits, health education actions and planning of the teams' work agenda to their routine labour activities.Brazilian health care systems have been subjected to many changes since 1988, when the new federal constitution (Brazilian major law) was promulgated. This Constitution instituted the National Health System – SUS ("Sistema único de Saúde") – which was to be organized based upon the principles of universality, equity, continuous care through different levels, administrative decentralization and community participation in decision-making.Over the last decade, a series of reforms have been undertaken, transferring responsibility for the administration and provision of public services in health to the level of the municipalities – one level below the states. In general, the management of the health system has improved with this transfer of federal resources and responsibility [1-3].Funding levels have increased, allowing an expansion of services – the most significant being the Family Health Programme (Programa de Saúde da Família or PSF, in Portuguese) which has to date been implemented in 60% of the municipalities and which has been linked to the development of a cadre of community health workers known as Health Communitarian Agents [4]. Finally, more democratic mechanisms for community participation in decision making were established.The Family Health Program (PSF), launched in 1995, is considered an innovative mechanism for extending access and promoting equity. The programme integrates public health actions with care and treatment and is based on many successful experiences as observed in other health systems, such as Canada, UK and Cuba [5,6].One of the main reasons for the success of this model is that it emphasizes health promot