Health promotion in primary care across Brazil: Genealogic-inspired qualitative study

Objective: To describe and analyze Health Promotion practices in Primary Health Care. Method: Genealogic-inspired qualitative, descriptive, and exploratory research conducted in a PHC service in Porto Alegre, Rio Grande do Sul, Brazil. Twenty-three semi-structured interviews were held with the service staff from February to May 2020. The data were qualitatively analyzed using genealogically inspired techniques, which allowed us to identify tensions, disputes, discourses, practices, and power relationships. Results: We established eight sets of Health Promotion practices: 1) Educational activities focused on behavioral/habit changes and development of personal abilities; 2) Intersectoral practices and community social networks involving other community equipment; 3) Practices that encourage community organization and participation; 4) Integrative and Complementary Health practices; 5) Practices that stimulate meeting people, sociability, art, and creativity; 6) Practices that encourage environmental and food sustainability; 7) Practices that stimulate income generation; 8) Community communication practices. Conclusion: We identified a heterogeneous field of practices to promote health established through the circulation of different types of knowledge and powers. The practices are permeated by discourses linked to neoliberal governability and practices that position themselves against such discourse.
 