The present study aims at reporting the contribuition of the local management process to the Health Centers maintained by the Health Bureau of the city of Ribeirão Preto. The authors discuss the limits emerged with the constitution of this administrative activity: to change it into a technical and rational activity applied to the services control and to the organization of the health care. They emphasize that within these limits it is possible to reconstruct a dynamic and integrated management process in which the technical, political and communicative dimensions are present aiming at obtaining a sanitary integration.