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Community health workers (CHWs) are framed as the link between communities and the formal health system. CHWs must establish trusting relationships with the community and with the broader health service. How to find the optimal balance between the various strands of work for CHWs, and how to formalise this, has been the focus of different studies. We performed an extensive documentary analysis of federal legislation in Brazil to understand the institutionalisation of the CHW workforce in Brazil over the last 3 decades. The paper offers three contributions to the literature: the development and application of an analytical framework to consider the institutionalisation process of CHWs; a historical analysis of the professional institutionalisation of CHW in Brazil; and the identification of the paradoxes that such institutionalisation faces: firstly, institutionalisation focused on improving CHW remuneration created difficulties in hiring and paying these professionals; when CHW are incorporated within state bureaucracy they start to lose their autonomy as community agents; and that the effectiveness of CHW programmes depends on the improvement of clinical services in the most deprived areas. [ABSTRACT FROM AUTHOR]

Despite the serious threat to public health that it represents, hazardous household waste (HHW) is not perceived as dangerous by a majority of the population. Existing waste management systems contribute to this misperception, by underestimating the importance of these residues. This, in practice, reflects the lack of knowledge of citizens about the risks and about their responsibility. This study aimed to identify the major HHW generated and disposal practices of the population of São Luís District and know the HHW management situation of the municipality of Canoas, Brazil. We conducted a neighborhood survey, identifying the generation and destination of 15 types of HHW. The situation of the management of this waste was obtained through consultations with the City of Canoas, where we observed little effective action to correct mismanagement. With the aim of improving the current administration, this paper proposes the use of the Family Health Strategy as a liaison for implementation of an appropriate hazardous household waste management program. The role of Community Health Workers restates the important potential for the integration of environmental education and preventive action. [ABSTRACT FROM AUTHOR]

The Secretary of Health State of Minas Gerais, with the support of the Ministry of Health, have been making extensive effort to universalize the primary health care, given its strategic role in the formation the networks of the health care in the Unique Health System (SUS). Therefore, began to encourage the adoption of the Family Health Teams through of the "Program Structuring Health at Home". Associated with this program, was created the Master Plan of the Primary Health Care (PDAPS), whose goal it's provide an instrument to territorial planning and management of these service, qualifying them to fulfill the role as gateway of the network of the health in the SUS. The aim of this paper is discuss the territorial planning of the primary health care and the networks of the health care the SUS in Minas Gerais, Brazil. The hypothetical premise of the discussion is the existential interdependence between primary health care, networks and the territory. The methodology is based on a theoretical study and descriptive, on one side, and a theorical analysis and critical, of another. Therefore, have a dimension of discovery of the relationship between networks, territory and primary health care, on one side, and a dimension of note about the ways how this is being planned, of another. The results indicate improvements in the construction of networks in Minas Gerais, but there are also theoretical issues and methodological that needs to be addressed, especially on the forms of territorial definition of the services. [ABSTRACT FROM AUTHOR]

Health care in Brazil is set as a unified system, running under a legal basis and protected by the Constitution. Health is positioned as a right of every citizen, and both models are defined with a view to the operation of services organized for this purpose. The first level in Brazil is called Basic Care, and its conceptual basis comes from the Primary Health Care (PHC). This paper aimed to understand and analyze how organized is the theoretical production of Public Health in Brazil about the social construction of health demand care in PHC, in order to create a reference to analyze it. The survey was conducted using the terms related to the initial problem: health care demand, basic health care and technical health care models. [ABSTRACT FROM AUTHOR]

This paper analyzes the conduct of the federal primary health care politics in Brazil in the 2000's, seeking to identify elements of continuity and change in the previous period. The research was based on the theoretical framework of historical institutionalism and the concept of path dependence. The methodology included a variety of strategies: literature review, document analysis, analysis of secondary databases, budget analysis and interviews with key stakeholders of the policy. It was possible to identify continuities and changes in the conduct of national policy for federal primary care during the study period. The predominance of continuities, emphasizing the persistence of the Family Health Program as a hegemonic strategy for reorientation of primary care in the country, creates a condition of path-dependence. There were also incremental changes, such as initiatives to strengthen inter-sectoral coordination and important innovations, notably the creation of the Centers for Family Health Support. There are, however, structural problems within primary care, and it is important to overcome them to enable the effective change in the health care model in the country. [ABSTRACT FROM AUTHOR]

This paper aims to problematize the itinerancy as a way to operationalize care in the territory. With the creation of the Unified Health System, the notion of territory has become an organizing principle of work processes in primary health care and mental health policies. In the delicate field of coordination between these policies, itinerant practices now have a strategic importance in the deinstitutionalization of practices and construction of integral care. We take the deinstitutionalization and the integrality as conceptual operators that make the difference that Psychiatric and Health reforms want to print in the care practices. Warned that by joining in a posture of active search in the life territory of users, the itinerant practices fall in a field of tensions, which can both be called to work as a part of the State apparatus to population control, as in a strategic place for the construction of a contextualized care to users" way of life. We believe that it is possible to resist the social control mandate and build an ethics of care with itinerancy to explore the political power of the movement and transform the users' territory in a laboratory for the invention of life. [ABSTRACT FROM AUTHOR]

: This paper is a country case study for the Universal Health Coverage Collection, organized by WHO. Mauricio Barreto and colleagues illustrates progress towards UHC and its monitoring and evaluation in Brazil. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]