This case study aimed to analyze the health care of families settled in the countryside of Pernambuco state, Brazil, through participant observation, individual interviews with health professionals and representative of the Landless Workers Movement (MST), focus groups with families from two settlements and field diary. Health practices were related to the popular care through the use of medicinal plants, preventive actions, such as vaccination, childcare, monitoring of hypertensive and diabetic patients, water treatment and waste destination. We identified that socioeconomic, cultural and educational factors had a negative impact on health conditions, while the training of professionals and the resolving capacity of Primary Care limited the supply of actions. Although health practices were in accordance with the National Primary Care Policy, there were gaps between making technical health and making health popular. The actions carried out by the Movement were highlighted, such as the diagnosis of health status and planning, based on popular education. The health needs presented by the families demanded of the teams specific skills and abilities for the integral health care implied with the socioeconomic, cultural and sanitary reality of the Agrarian Reform settlements.
health policy; primary care; family health; rural health