The article discusses the decision making in the municipal management from the managers speeches of the Family Health Strategy (ESF). It is about a research with qualitative approach, carried out by means of direct observation of a health team and interviews. Therefore, it was impounded that the ESF managers are assumed as the center of the team, prevailing the ranking of relationships and decision makings centered on management. Thus, it is necessary to understand the power structures within health institutions, once are the daily relationships that determine the management progress. It is needed that those spaces enlarge the listening moments for workers in the shared management process.
Primary Health Care; Family Health Strategy; Health management; Health policy