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Abstract
Universal health systems oriented by Primary Health Care (PHC) present better population outcomes. This article addresses the situation of access to care in Brazilian PHC. A non-systematic narrative review was carried out, which included published studies and empirical experiences in several services and municipalities. Three thematic axes guide the present study: (1) Current access situation in Brazilian PHC; (2) Problems and challenges; and (3) Strategies for expanding access in PHC. Research shows that access to PHC increased with the expansion of the Family Health Strategy (FHS), but still remain insufficient. The main barriers to access include: undersizing and underfunding of PHC, excessive patient-list linked to FHS teams, reduced number of specialist physicians, difficulty in interiorizing/fixing FHS professionals, and excessive municipal autonomy in the management of PHC services. To improve and qualify the access in PHC, it is necessary to increase federal investments, expand FHS coverage, reduce patient-list linked to FHS teams, increase medical training in family and community medicine, optimize nursing clinics, diversify communication media with users, and enhance appointment flexibility. In conclusion, to strengthen PHC it is strategical to stimulate access to longitudinal care.
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Copyright (c) 2025 Ariane Abreu Tsutsumi, Kerolaine Silva Fonseca, Roberta Priscila Baccili Castilho Matos, Flavia Renata Bradassio Migliorança, Elton Pessoa dos Santos, Juliana Paes de Oliveira Chriguer, Vinícius Parron Keller, Victoria Vieira Vockes, Ana Flávia Bomfim Souza, Poliana Barros de Araujo, Sanzylly Soares França Ferreira , Danielle Ferreira do Nascimento Linard, Nathalia Pereira Magalhães, Antonio Denizar Costa Neto, Abdon Adynan De Araujo Sousa, Catharina Noleto Gontijo e Silva, Nicole Farias Siqueira, Rafael Grilo Pestana Bittar, Adriana Santos Crepaldi