This article approaches the challenges posed by the need to conceive and implement a culture of evaluation. For this purpose it discusses the relations and differences between evaluative research, normative evaluation and decision-making. The analysis shows the capacity to institutionalize the evaluation as a tool for improving the health system to be self-contradictory, for presupposing that the information produced by an evaluation helps to rationalize the decision processes. It is affirmed that the degree to which the results of an evaluation are taken into consideration by decision-makers varies according to their credibility, theoretical foundation and pertinence. What can be observed is that the actors occupying different positions are unable to agree upon the pertinence of the results produced by the evaluation. For turning evaluation into a core-strategy for transforming the health system the author suggests to create the conditions for a truly critical judgment through implementation of strategies that favor professional qualification and instruction, debates, reflections and the opening of new horizons of intervention. Institutionalize the evaluation implies in the first place in questioning the capacity of this evaluation to produce the information and judgments the decision-makers need for improving the performance of the SUS.
Evaluation; Institutionalization of the evaluation; Primary health care
