Advances, challenges, and perspectives for strengthening the institutional capacity, sustainability, and resilience of Primary Care in national health systems

THIS ISSUE OF THE JOURNAL ‘SAÚDE EM DEBATE’ is the result of the commitment of the Center for Strategic Studies (CEE) of the Oswaldo Cruz Foundation (FIOCRUZ), in partnership with the Brazilian Center for Health Studies (CEBES), to disseminate research and studies on the dilemmas and institutional challenges of the contemporary public health sector. The Special Thematic Issue (NTE) offers a comprehensive and diverse panel of articles, essays, digests, and reviews from a domestic and international perspective on resilience, sustainability, and institutional capacity in the health sector.

The first set of contributions addresses, with articles and essays, the COVID-19 pandemic. The persistence of the topic on the scientific agenda is due to the scale of both individual and collective damage that this disease still causes. In the initial scenario of uncertainty about the capacity to respond to the pandemic, the approach from the perspective of resilience became imperative and crucial for the sustainability and institutional future of the field of public health¹.

The understanding of such relevance resulted in contributions to the NTE of unpublished works that address, directly or indirectly, the responsiveness, absorption, and recovery to clashes of actors, organizations, and sectoral public policies. The works point to the construction of a research agenda on the capacity of national systems or health organizations to respond to radical disturbances. It is assumed, in this sense, that the identification of resilience can favor the strengthening of the health system and ensure collective protection.

The second set of works deals with the foreseeable pressures and disturbances that affect the functioning of the health sector. The Brazilian public health sector – Unified Health System (SUS) – has particularities that accentuate the difficulties of dealing with foreseeable disturbances, but difficult to manage, due to the scale, diversity, socioeconomic inequalities, the deficit of governance, and the political dissent, among other structural and conjunctural weaknesses².

To reflect on these particularities, the NTE brings together several studies and research on the functioning of the SUS, with special emphasis on dilemmas and innovations in Primary Health Care (PHC). When considering the programmatic initiatives led by PHC, we also sought to value the experiences that respond to the expectations of users, public managers, and the health promotion agenda in the country.

Referências

• ¹
  Massuda A, Malik AM, Vecina Neto G, et al. A resiliência do Sistema Único de Saúde frente à COVID-19. Cad. EBAPE.BR. 2021 [acesso em 2022 dez 20]; 19(esp):735-744. Disponível em: https://www.scielo.br/j/cebape/a/PfnQv8mykrVxTDjVgD8Sfgs/?lang=pt&format=pdf.
  » https://www.scielo.br/j/cebape/a/PfnQv8mykrVxTDjVgD8Sfgs/?lang=pt&format=pdf.
• ²
  Costa NR. Austeridade, predominância privada e falha de governo na saúde. Ciênc. saúde coletiva. 2017 [acesso em 2022 dez 20]; 22(4):1065-1074. Disponível em: https://www.scielo.br/j/csc/a/yT9WQtPtcQVcMgpyQFRm4fs/?lang=pt.
  » https://www.scielo.br/j/csc/a/yT9WQtPtcQVcMgpyQFRm4fs/?lang=pt.

Publication Dates

• Publication in this collection
  28 Apr 2023
• Date of issue
  Dec 2022