Community participation in the Family Health Strategy: Historical, theoretical, and methodological aspects of its...

This article aims to review approaches to community participation in the historical and social context of Primary Health Care (PHC) to reflect on the critical reconstruction of the care model of the Family Health Strategy (ESF) and the Unified Health System (SUS). We present the results of several evaluative studies with users and health professionals, highlighting challenges to community participation in PHC: the population's knowledge of the SUS and health as a human right; the imposition of social determinants of the health-disease process that weakens population participation; a shortage of financial and material resources to run activities; workers' limited time and focus in developing these activities; a lack of management support for these initiatives; and a lack of interest on the part of some professionals in the dimension of community participation, preferring to focus exclusively on individual clinical care. The conclusion is drawn regarding the importance of community participation in the ESF for building a shared agenda between service providers, management, and the population to mobilize strategies that affirm life, well-being, and healthy and sustainable territories.