Access to healthcare in the Family Health Strategy: balance between same day access and prevention/health promotion

This article presents some guidelines for organizing the working process in Primary Health Care (PHC) and Family Health Strategy (FHS) concerning the challenges of providing access and balancing the everyday healthcare services activities which includes health promotion and prevention of diseases, as well as access for those suffering ill-health. Firstly, it addresses some specific ideas about the importance of access to the quality of the health care services, followed by a brief critique - based on Geoffrey Rose's concepts - to the high-risk preventive strategy that has had high impact on health care organizational routines. Secondly, it contextualizes health promotion and its relations to individual health care in PHC/FHS, discussing the synergic potential of care and health promotion in their individual and collective dimensions to transcend the biomedical-mechanistic model. Finally, based on the above topics and concerning their operational consequences, as well as using a concrete example, it outlines general guidelines for organizing the working process and the agenda of doctors and nurses in the FHS, in order to facilitate both balance and synergy between access to health care and prevention/promotion, aiming to strengthen the FHS as local coordinator of care and main entrance of the Brazilian National Health System.

Primary Health Care; Family Health Strategy; Health Services; Access; Disease Prevention; Health Public Policy