ABSTRACT:
BACKGROUND The Family Health Strategy, Brazil’s main Primary Health Care (PHC) model, is grounded in territorialization, recognizing territory as a socially and politically constructed space.¹ The community-based approach is a relational technology that promotes proximity between health professionals and communities and integrates clinical care with social determinants to address social disadvantages and their health effects.¹,² It aligns with Popular Health Education (PHE) and Emancipatory Care (EC), emphasizing horizontal dialogue, local knowledge, critical reflection, autonomy, and the reduction of power asymmetries in care practices.³-⁵ In Rio de Janeiro (RJ), expanded PHC coverage increased service capacity⁶, but understaffed teams face clinical, surveillance, and administrative demands, limiting community-based approaches. This study analyzed community-based approach experiences in RJ state (2015–2025) from the perspectives of PHE and EC. METHODS A literature review in the Virtual Health Library (BVS/VHL) and the Digital Library of Theses and Dissertations of the State University of Rio de Janeiro (BDTD-UERJ), using Boolean operators in title, abstract, and subject fields, identified 273 publications. Of these, 17 studies were selected and classified by type of community approach, thematic focus, teaching methodologies, and political-pedagogical perspectives. RESULTS Community-based approach has been predominantly organized in formats such as groups, lectures, and campaigns, oriented toward information transmission and behavior change. Despite the presence of participatory dynamics, a depositary political-pedagogical perspective prevails, with limited community protagonism in defining themes and strategies. This pattern is associated with the biomedical training of professionals and their insertion in services governed by managerial logics focused on targets and productivity, with limited time and institutional support for territorial actions.⁷⁻⁹ CONCLUSION Community-based practices in PHC in RJ state diverge from PHE and EC principles. These findings raise a question: whose interests are served by non-critical and non-emancipatory practices that limit the transformative potential of health and social action within Brazil’s Unified Health System?