Integralidade e vigilância em saúde

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O desafio da integralidade segundo as perspectivas da vigilância da saúde e da saúde da família Integrality (comprehensiveness): from the viewpoint of health care and the recent proposals regarding basic assistance in Brazil

Carlos Eduardo Aguilera Campos 1

1 Departamento de Medicina Preventiva da Faculdade de Medicina e Núcleo de Estudos de Saúde Coletiva/UFRJ. Edifício do Hospital Universitário Clementino Fraga Filho. Av. Brigadeiro Trompowsky s/n, 5o andar, Ala Sul, sala 33, Ilha do Fundão, 21941590, Rio de Janeiro RJ. [e-mail]

Abstract Multiple facets, related to the definition of policies, the structuring of knowledge and the implementing of practices in the health services, interact among themselves. This brings to light, as a final result (output), the manner in which health services are rendered within a certain historical context (concept), and the availability or the scarcity of certain groups of activities and health services (in this country). It is essential to understand these interactions in order to be able to evaluate the course of action to be followed by health policies in Brazil. Considering, as our reference point, the Constitutional principle of integrality (comprehensiveness) of health care, and the challenges posed by its implementation, we analyze the theoretical formulations related to the concept of health care and the changes that have been implemented by the Ministry of Health in the areas of Basic Assistance and Family Health (Programs). We also put on the discussion table to what extent (measures) these formulations, propositions and initiatives have effectively been contributing, today, to the development of the Unified Health System (SUS). Key words Health policy, Health System Organization, Unified Health System, Primary care

Resumo Múltiplos aspectos relacionados à formulação de políticas, à construção do conhecimento e à implementação das práticas no setor saúde interagem mutuamente e têm como produto