0321/2025 - Agentes Comunitárias na Estratégia de Saúde da Família: 30 anos de resistência e avanços. Community Health Workers in the Family Health Strategy: 30 years of resistance and achievements
Este artigo analisa a trajetória das Agentes Comunitárias de Saúde (ACS) na Estratégia Saúde da Família em seus 30 anos, destacando seu papel na consolidação da Atenção Primária (APS) no SUS. Objetiva compreender como as políticas públicas influenciaram seu trabalho, formação e profissionalização, além dos desafios enfrentados. Utiliza abordagem histórico-crítica, com análise documental (leis, portarias) e revisão bibliográfica, baseada nos referenciais da APS Integral e da determinação social da saúde. Conclui-se que: 1) as ACS passaram de ocupação para profissão regulamentada, com avanços legislativos; 2) seu trabalho enfrenta tensões entre burocracia e atuação comunitária, agravadas pela redução de sua presença nas equipes; e 3) lidam com violência, crise socioambiental e desinformação. Apesar das adversidades, as ACS se consolidaram como trabalhadoras essenciais ao SUS, fundamentais para a territorialização, a orientação comunitária e o trabalho multidisciplinar, cujo futuro do trabalho depende das orientações que prevalecerão na condução da APS no Brasil.
Palavras-chave:
Atenção Primária em Saúde; Agente comunitário de saúde; política de saúde; processo de trabalho em saúde.
Abstract:
This article analyzes the trajectory of Community Health Workers (CHWs) in the Family Health Strategy over its 30 years, highlighting their role in consolidating Primary Health Care (PHC) within Brazil's Unified Health System (SUS). It aims to understand how public policies shaped their work, training, and professionalization, and the challenges faced. Using a historical-critical approach, it combines document analysis (laws, ordinances) and literature review, aligned with Comprehensive PHC and social determination of health frameworks. Key findings: (1) CHWs evolved from an occupation to a regulated profession with legislative achievements; (2) their work faces tensions between bureaucratic and community roles, aggravated by the decrease in their presence within the teams, harming comprehensive PHC; and (3) they confront violence, socio-environmental crises, and misinformation. Despite the adversities, CHWs have established themselves as essential workers for the Unified Health System, crucial for territorialization, community orientation, and multidisciplinary work, whose future depends on the direction that will prevail in the conduction of PHC in Brazil.
Keywords:
Primary Health Care; Community Health Workers, Health Policy; Healthcare Work Process
Community Health Workers in the Family Health Strategy: 30 years of resistance and achievements
Resumo (abstract):
This article analyzes the trajectory of Community Health Workers (CHWs) in the Family Health Strategy over its 30 years, highlighting their role in consolidating Primary Health Care (PHC) within Brazil's Unified Health System (SUS). It aims to understand how public policies shaped their work, training, and professionalization, and the challenges faced. Using a historical-critical approach, it combines document analysis (laws, ordinances) and literature review, aligned with Comprehensive PHC and social determination of health frameworks. Key findings: (1) CHWs evolved from an occupation to a regulated profession with legislative achievements; (2) their work faces tensions between bureaucratic and community roles, aggravated by the decrease in their presence within the teams, harming comprehensive PHC; and (3) they confront violence, socio-environmental crises, and misinformation. Despite the adversities, CHWs have established themselves as essential workers for the Unified Health System, crucial for territorialization, community orientation, and multidisciplinary work, whose future depends on the direction that will prevail in the conduction of PHC in Brazil.
Palavras-chave (keywords):
Primary Health Care; Community Health Workers, Health Policy; Healthcare Work Process
Morosini, MVGC, Fonseca, AF, MEYER, APGFV. Agentes Comunitárias na Estratégia de Saúde da Família: 30 anos de resistência e avanços.. Cien Saude Colet [periódico na internet] (2025/set). [Citado em 17/06/2026].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/agentes-comunitarias-na-estrategia-de-saude-da-familia-30-anos-de-resistencia-e-avancos/19797
