Reflections on the role of the State Health Secretariats in the implementation and development of and development of primary health care in Brazil
DOI:
https://doi.org/10.5712/rbmfc21(48)4728Keywords:
Politics, Decentralisation, Health management, Primary health careAbstract
This reflective-analytical essay examines the effects of municipalising health services, the challenges of regionalisation, and the role of State Health Secretariats (SES) in strengthening primary health care (PHC) in Brazil. The Family Health Strategy has established itself as the primary PHC model, achieving notable improvements in health indicators. However, challenges remain, including inequality of provision, shortages of professionals, and weaknesses in municipal management. Many municipalities, particularly smaller ones, lack the structural, financial and technical resources necessary to provide comprehensive care. The text proposes a greater role for the SES, particularly within the Regional Inter-Management Commissions (CIR), to promote collaborative PHC management and support municipalities with issues such as planning, professional training, infrastructure and funding. In conclusion, strengthening regional management is essential for advancing the Unified Health System and can generate positive impacts beyond health, contributing to wider regional development.
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Copyright (c) 2026 Patricia Sampaio Chueiri
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