Keywords
Public Health Policies
Unified Health System
Social Determinants of Health
Public Health
How to Cite
Abstract
The aim was to analyze, through scientific literature, the advances, contradictions, and challenges in the implementation of Health Promotion in Brazil within the scope of the Unified Health System (SUS). An integrative literature review was conducted, with the guiding question based on the PICo strategy. Searches were performed in the LILACS, SciELO, and MEDLINE/PubMed databases, using the descriptors: "Health Promotion," "National Health Promotion Policy," "Unified Health System," and "Social Determinants of Health." Original articles in Portuguese, English, and Spanish were included. The data were synthesized and analyzed descriptively and thematically. Of 482 studies, 18 were selected. The analysis shows that progress is concentrated in the robust regulatory framework and the creation of programs with great potential for widespread reach, such as the Health Academy Program. The contradictions lie in the persistence of a biomedical model that prioritizes disease prevention to the detriment of actions addressing social determinants, and in the dissonance between political discourse and funded practice. The main challenges are the chronic underfunding of the SUS (Brazilian Unified Health System), the fragility of intersectoral collaboration, the difficulty in guaranteeing effective social participation, and the need to reorient the training of health professionals.
References
World Health Organization. Ottawa Charter for Health Promotion [Internet]. Geneva: WHO; 1986 [cited 2024 Oct 15]. Available from: https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference
Paim JS. O que é o SUS. Rio de Janeiro: Editora Fiocruz; 2009.
Brasil. Ministério da Saúde. Política Nacional de Promoção da Saúde (PNPS): Anexo I da Portaria de Consolidação nº 2, de 28 de setembro de 2017 [Internet]. Brasília: Ministério da Saúde; 2018 [citado 2024 Out 15]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_promocao_saude.pdf
Castiel LD, Guilam MCR, Ferreira MS. Correndo o risco: uma introdução aos riscos em saúde. Rio de Janeiro: Editora Fiocruz; 2010.
Czeresnia D. O conceito de saúde e a diferença entre prevenção e promoção. In: Czeresnia D, Freitas CM, organizadores. Promoção da saúde: conceitos, reflexões, tendências. 2ª ed. Rio de Janeiro: Editora Fiocruz; 2009. p. 43-57.
Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 2008 Dec;17(4):758-64. DOI: 10.1590/S0104-07072008000400018.
The Joanna Briggs Institute. Joanna Briggs Institute Reviewers' Manual: 2014 edition [Internet]. Adelaide: JBI; 2014 [cited 2024 Oct 15]. Available from: https://jbi.global/sites/default/files/2019-05/JBI_Reviewers_Manual_2014.pdf
Malta DC, Silva MMA, Albuquerque GM, Lima CM, Cavalcante T, Jaime PC, et al. A implementação da Política Nacional de Promoção da Saúde, um balanço, 2006 a 2014. Ciênc Saúde Coletiva. 2014 Nov;19(11):4301-13. DOI: 10.1590/1413-812320141911.07732014.
Funcia FR. Financiamento do SUS: a luta continua. Saúde Debate. 2019 Sep;43(spe5):8-13. DOI: 10.1590/0103-11042019s500.
Akerman M, Mendes R, Bógus CM, Westphal MF, Bichir A, Pedroso M. Intersetorialidade? Reflexões sobre a governança de projetos e programas em saúde. Saude Soc. 2016 Mar;25(1):7-19. DOI: 10.1590/S0104-12902016146192.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2025 Global Academic Nursing Journal