The building of a health center from the point of view of planners and doctors: a case study

Objective The relationship between the structure of the health center and the population seeking comprehensive health care. Method It was studied a health center of the county of S. Paulo (Brazil) in the period of 1989 to 1992. The speech of managers at three levels, regional, district and local, as well as the speech of physicians,cho were working at the Primary Health Care Units, Ic as analysed The concept of comprehensive care covers five dimensions: 1) the individual and not the illness itself as the primary aim; 2) the individual or group as a whole; 3) the intervention provided by other types of care; 4) different treatment for those who live in different situations; 5) the intervention in the general living conditions of the population. Results It was concluded that the relationship between the district structure and the seek for comprehensive care Ir as dependent on the following: health planning, emphasizing a wider view of the real life situation of the population connected to the Primary Health Care Unit; the kind of inter action between different members of-the staff; better organization of the work and of the reference and counter-reference networks and a good relationship with other health departments, thus making possible better comprehensive care. Comments Being a local care unit does no! enable the health district to meet the challenge of being the "locus" of knowledge, work and power as between the population and the workers and among the different groups within these two sectors.