Community oriented primary care and health promotion in Brazil: lessons from a doctoral study grounded in primary health care
1
Ministry of Health, Brasilia, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Health promotion as a public policy requires institutional arrangements that enable population participation, territorial action, and continuous use of local health information. Community oriented primary care offers a structured approach to integrate these elements within primary health care. Developed in the 1940s in South Africa by Sidney and Emily Kark, this model combines community inquiry, participatory planning, and ongoing evaluation of health actions.¹–⁵ In Brazil, the Family Health Strategy incorporates related principles but still faces challenges in consolidating participation as a core practice of health promotion.¹,⁸–¹⁰
METHODS:
This exploratory and evaluative study is part of a doctoral thesis defended in 2025 and applies the conceptual framework of community oriented primary care.¹ Data were collected through an online questionnaire using a Policy Delphi approach. A total of 510 participants with experience as users of the Family Health Strategy completed a structured electronic survey including Likert scale items and open ended questions. Sampling was intentional and non probabilistic, prioritizing diversity of perspectives rather than statistical representativeness. Descriptive and interpretative analyses focused on links between community participation, territorial practices, and health promotion.
RESULTS:
Findings indicate that practices aligned with the main stages of community oriented primary care—community inquiry, shared diagnosis, joint planning, territorial intervention, and continuous assessment—strengthen health promotion outcomes within primary care.²–⁷ Participants reported improved alignment between services and local needs, stronger bonds with health teams, and greater recognition of health as a social right. However, limitations persist, including weak institutionalization of participatory decision making and inconsistent use of community generated data.⁸–¹⁰
CONCLUSIONS:
Integrating community oriented primary care principles into the Family Health Strategy reinforces health promotion as a political, social, and territorial process.¹,⁶,⁷ This approach remains highly relevant for strengthening primary health care systems in low and middle income settings.⁹,¹⁰
Health promotion as a public policy requires institutional arrangements that enable population participation, territorial action, and continuous use of local health information. Community oriented primary care offers a structured approach to integrate these elements within primary health care. Developed in the 1940s in South Africa by Sidney and Emily Kark, this model combines community inquiry, participatory planning, and ongoing evaluation of health actions.¹–⁵ In Brazil, the Family Health Strategy incorporates related principles but still faces challenges in consolidating participation as a core practice of health promotion.¹,⁸–¹⁰
METHODS:
This exploratory and evaluative study is part of a doctoral thesis defended in 2025 and applies the conceptual framework of community oriented primary care.¹ Data were collected through an online questionnaire using a Policy Delphi approach. A total of 510 participants with experience as users of the Family Health Strategy completed a structured electronic survey including Likert scale items and open ended questions. Sampling was intentional and non probabilistic, prioritizing diversity of perspectives rather than statistical representativeness. Descriptive and interpretative analyses focused on links between community participation, territorial practices, and health promotion.
RESULTS:
Findings indicate that practices aligned with the main stages of community oriented primary care—community inquiry, shared diagnosis, joint planning, territorial intervention, and continuous assessment—strengthen health promotion outcomes within primary care.²–⁷ Participants reported improved alignment between services and local needs, stronger bonds with health teams, and greater recognition of health as a social right. However, limitations persist, including weak institutionalization of participatory decision making and inconsistent use of community generated data.⁸–¹⁰
CONCLUSIONS:
Integrating community oriented primary care principles into the Family Health Strategy reinforces health promotion as a political, social, and territorial process.¹,⁶,⁷ This approach remains highly relevant for strengthening primary health care systems in low and middle income settings.⁹,¹⁰
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
