Primary health care: guidelines, challenges and recommendations. A review of international literature

We present a review of international literature, aiming at identifying and analyzing the diversity of themes associated to Primary Health Care. We focused on the characteristics of the work of health care personnel, its guidelines and its political and clinical challenges. We analyzed the abstracts of 105 articles published between 1999 and 2009. Then, we integrally read and analyzed 34 articles, creating thematic categories. We compared data to Brazilian literature on the subject. The articles focus on physician's work and emphasize the notion of evidence-based medicine. They mainly approach the implementation of guidelines to primary health care and the professional-patient relations. They acknowledge the complexity of Primary Care and the importance of patient-centered care. However, they do not mention integrated actions with other public policies. The authors do not radically overthrow the cure-centered specialism and they do not write about fostering patients' participation, autonomy and empowerment. They acknowledge the need to approach "human" issues at the levels of guidelines implementation, clinical practices etc. Nevertheless, in general, these authors are far from the social sciences.

primary health care; health personnel; health planning guidelines; evidence-based medicine