20 Anos da Política Nacional de Atenção Básica Impactos no Sistema Único de Saúde e nos Indicadores de Saúde

Clara Wirginia de Queiroz Moura; Vanessa Maria Alves da Silva Pereira Oliveira; Mariana Sousa Avelino; Ana Larissa Braga Chaves; Vitória Neíse Fontenele Teixeira; Maysa Mariana Furtado Moreira; Roberto Sales Aguiar Filho; Maria Socorro de Araújo Dias

doi:10.1590/SciELOPreprints.12167

##article.authors##

Clara Wirginia de Queiroz Moura INTA University Center (UNINTA) Itapipoca Campus https://orcid.org/0000-0003-1089-8208
Vanessa Maria Alves da Silva Pereira Oliveira INTA University Center (UNINTA) Itapipoca Campus https://orcid.org/0009-0003-0603-1377
Mariana Sousa Avelino INTA University Center (UNINTA) Itapipoca Campus https://orcid.org/0009-0005-6167-269X
Ana Larissa Braga Chaves INTA University Center (UNINTA) Itapipoca Campus https://orcid.org/0009-0008-0438-7456
Vitória Neíse Fontenele Teixeira UNINTA Fortaleza College https://orcid.org/0009-0008-5452-0382
Maysa Mariana Furtado Moreira INTA University Center (UNINTA) Itapipoca Campus https://orcid.org/0009-0004-1245-3557
Roberto Sales Aguiar Filho INTA University Center (UNINTA) Itapipoca Campus https://orcid.org/0000-0001-9979-635X
Maria Socorro de Araújo Dias State University of Vale do Acaraú https://orcid.org/0000-0002-7813-547X

DOI:

https://doi.org/10.1590/SciELOPreprints.12167

Keywords:

Family Health, Primary Health Care, Public Health

Abstract

In a context of profound political, institutional and social transformations, discussing the impacts of the National Primary Care Policy (PNAB) is essential for the qualification of Primary Health Care (PHC) as the basis of the Unified Health System (SUS). The study therefore seeks to analyse the impacts and evolution of the PNAB in the SUS, with a focus on PHC in lines of care and life cycles. The methodological approach is based on documentary analysis and a narrative review of the literature, articulating the PNAB's legal frameworks. The PNAB underwent important normative milestones in 2006, 2011 and 2017, which reflect different conceptions of the role of PHC in the SUS. This reveals significant progress in consolidating the ESF as a priority model for organising services, with a direct impact on expanding access and coordinating care. The set of policies implemented in the PNAB has contributed to important improvements in health indicators, such as the reduction in infant mortality and hospitalisations for PHC-sensitive conditions. The incorporation of lines of care and life cycles as structuring axes of care reaffirmed the commitment to comprehensiveness and equity.

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Author Biographies

Clara Wirginia de Queiroz Moura, INTA University Center (UNINTA) Itapipoca Campus

Professor and Coordinator of Extension and Social Responsibility at Centro Universitário Inta (UNINTA) Itapipoca Campus. Master in Family Health from the Federal University of Ceará, specializing in research line: Permanent Education Strategies and Professional Development in Family Health. Specialist in Pediatrics through the Integrated Health Residency Program of the School of Public Health of Ceará - RIS-ESP/CE in partnership with the Albert Sabin Children's Hospital. Specialist in Intensive Care from the School of Public Health of Ceará, ESP/Ce. Specialist in Family Health from the School of Public Health of Ceará, ESP/Ce. Specialist in Strategies for Combating Violence Against Women, from ESP/Ce. Training in Preceptorship from the School of Public Health of Ceará. Bachelor's in Physiotherapy from Unichristus. Pedagogue with specialization in Physiology, Biochemistry, and General Biology from the State University of Ceará. Training in Youth and Adult Education from the Federal University of Ceará. Basic training in sign language, Libras, from the Institute of Education of Ceará - SEDUC. Areas of study and practice: Physiotherapy; Childhood and Youth; Early Stimulation; Professional Training in Health; Neonatology; Collective Health and Family Health; Palliative Care; General Biology; Youth and Adult Education, Education. Served as Pedagogical Manager for the Bachelor of Physiotherapy course (2022 - 2023) and as a professor in the Nursing, Nutrition, Psychology, and Medicine courses. Currently, she is a professor in the Physiotherapy and Dentistry courses and contributes to other courses through the Institutional Coordination of Centro Universitário Inta (UNINTA) Itapipoca Campus-CE. Delegate of Itapipoca - 4th National Conference on Work and Health Education Management (CNGTES).

Vanessa Maria Alves da Silva Pereira Oliveira, INTA University Center (UNINTA) Itapipoca Campus

Seventh-semester Bachelor of Dental Surgery student at Centro Universitário INTA (UNINTA), Itapipoca Campus, Ceará, Brazil.

Mariana Sousa Avelino, INTA University Center (UNINTA) Itapipoca Campus

Physiotherapist from Centro Universitário INTA (UNINTA) Itapipoca Campus (2022). Post-graduated in Neurofunctional Physiotherapy with specialization in Motor Learning in Human Growth and Development from Faculdade Metropolitana do Estado de São Paulo (2023/2024). Pursuing a post-graduate degree in Aesthetic Physiotherapy from Faculdade do Leste Mineiro. Pursuing a post-graduate degree in Urgency, Emergency, and ICU from Centro Universitário INTA (UNINTA) Itapipoca Campus. Scholar of the Institutional Program of Scientific Initiation Scholarships - PIBIC/CNPq of the Scientific and Technological Initiation Scholarship Program (2021/2022). Has experience in Neurofunctional Physiotherapy with an emphasis on Motor Learning in Growth and Development, Dermatofunctional Physiotherapy, and Integrative Therapies. Member of the Research Group on Health Promotion and Physical Exercise (GPPSEF).

Ana Larissa Braga Chaves, INTA University Center (UNINTA) Itapipoca Campus

Bachelor's student in Physiotherapy at Centro Universitário INTA (UNINTA) Itapipoca Campus. Member of the Research Group on Health Promotion and Physical Exercise (GPPSEF). Was part of the MOVIMENTAR Extension Project and the Multidisciplinary Academic League in Cardiology (LAMCARDIO). Director of Marketing and Vice-President of the Academic League of Physiotherapy and Integrative Health Practices (LAFIPIS). Treasurer of Uninta nas Escolas. Vice-President of the Academic Center of Physiotherapy for 2025 with the Berta Bobath slate, at Centro Universitário INTA (UNINTA) Itapipoca Campus. Scholar of the Scientific and Technological Initiation Scholarship Program.

Vitória Neíse Fontenele Teixeira, UNINTA Fortaleza College

Physiotherapy student at Faculdade UNINTA Fortaleza; has an award-winning work in the University Highlight Award 2024 in the scientific category of Physiotherapy; participates in the Family Research Group at Faculdade UNINTA Fortaleza; participates in the Interdisciplinary Study Group on Discursive Practices for Textual Construction at Faculdade UNINTA Fortaleza; participates in the Academic League of Non-Communicable Chronic Diseases at Faculdade UNINTA Fortaleza, participates in the research group of the Academic League of Non-Communicable Chronic Diseases at Faculdade UNINTA Fortaleza; participates in the Academic League of Women's Health Education at Faculdade UNINTA Fortaleza; participates in the Multidisciplinary Oncology Research Group at Faculdade UNINTA Fortaleza.

Maysa Mariana Furtado Moreira, INTA University Center (UNINTA) Itapipoca Campus

Bachelor's Degree in Psychology from the Federal University of Piauí - UFPI (2015). Specialist in Cognitive Therapies from Faculdade Itaquá. Currently, she is the Technical Responsible Psychologist for the Applied Psychology Service - SPA at UNINTA Itapipoca Campus - CE. She has experience in the field of Psychology, with an emphasis on Health Psychology. She has worked as an Institutional Psychologist at UNINTA Itapipoca Campus - CE. Experience in Hospital Psychology at the Regional Hospital of Campo Maior - PI. Experience at CAPS I in Campo Maior - PI. Experience at TRON Educational Robotics. Experience in the SUAS (Unified Social Assistance System) as a psychologist for the CREAS (Reference Center for Specialized Social Assistance) in the city of Cocal de Telha - PI.

Roberto Sales Aguiar Filho, INTA University Center (UNINTA) Itapipoca Campus

Holds a degree in Dentistry from the University of Fortaleza (2008). Currently, he is the coordinating professor of the Implantology courses at São Leopoldo Mandic Fortaleza. Specialist in Dental Prosthetics, Implantology, and Family Health. Master's in Dental Clinic with a concentration area in Dental Prosthetics. Manager of the UNINTA-Itapipoca School of Dentistry clinic.

Maria Socorro de Araújo Dias, State University of Vale do Acaraú

Public health nurse. Master and Doctor in Nursing from the Federal University of Ceará (UFC), with Postdoctoral studies at the State University of Ceará (UECE). Associate Professor at the State University Vale do Acaraú (UVA). Deputy Coordinator, permanent faculty member, and member of the Pedagogical Nucleus of the Graduate Program in Family Health - PPGSF (RENASF/UVA). Permanent faculty member of the Academic Master's in Family Health (UFC). She is part of the Executive Nucleus of the Working Group on Health Promotion and Sustainable Development of the Brazilian Association of Collective Health (ABRASCO), having been in coordination from 2020 to 2022, and rejoining as a member of the executive group in the current administration (2024-2026). Founder and leader of the Research Group: Laboratory of Social Research, Transformative Education, and Collective Health (LABSUS). She is the Coordinator of the Nucleus of Health Evidence in Sobral (EvipNet Brazil Network) and a researcher for the Primary Healthcare Network, the Observatory of Public Policies and Health Systems of Ceará ObservaCE/Oswaldo Cruz Foundation - Ceará, and the Nós APS Brasil Group. She is a member of the Technical-Scientific Advisory and Evaluation Chamber for Innovation (Public Health, Family Medicine, and Neglected Diseases) of the Cearense Foundation for Scientific and Technological Development (FUNCAP). She served as a director and researcher at the Visconde de Saboia School of Public Health (ESP-VS) (2000-2021). She was part of the Management Collegiate of the Knowledge Exchange between Brazil and Canada in the area of Management and Human Resources Training by competencies in Health Training Schools in the State of Ceará (2007-2012). She coordinates the Program of Education for Work in Health (PET-Equity), involving five undergraduate courses and the Sobral Health Secretariat, having also coordinated the four previous editions and participated in 11 editions. She was a Member of the Steering Group of the Brazilian Network of Public Health Schools (RedEscola) (2016/2018). Evaluator of the National System of Higher Education Evaluation - BASis, since 2006. Member of the committee of elaborators and reviewers of items for the National Item Bank (BNI) of the National Performance Exam - Enade. Peer Evaluator for the Nursing Degree within the framework of the ARCU-SUR System. Editor of the Journal of Public Policies - Sanare (ISSN: 2317-7748) and Revista Essentia (ISSN: 1516-6406). Reviewer for the periodicals: Interface - Comunicação, Saúde e Educação (ISSN: 1807-5762), Ciência e Saúde Coletiva (ISSN: 1678-4561), Revista Saúde e Sociedade (ISSN: 0103-1104), Revista Saúde em Debate (ISSN: 2358-2898) and Revista Mineira de Enfermagem - REME (ISSN: 2316-9389). She coordinated the National Research on the Evaluability of the National Health Promotion Policy (PAHO - 2022/2023). She was a guest editor and coordinated the thematic issue "Paths of Promotion and Health Care" of the journal Ciência Saúde Coletiva. She also integrated the team of guest editors in the supplement: 'Family Health Strategy: resonances in care, management, education and health promotion" of the Interface journal. She coordinates the Research: PRO-EQUITY POLICIES: Concept analysis, resonances on social determinants and technology for knowledge translation (CNPq). She is part of research teams in national multicentric research and with international partnerships. She has published 163 articles in specialized journals. She has written 81 book chapters, and published/organized 39 books. She researches the following topics: Policy Evaluation, Health Promotion, Health Education, and Interprofessional Education.