Community workers in Primary Health Care in Brazil: an inventory of achievements and challenges

ABSTRACT The article analyzed the construction of the profile of professionals internationally known as Community Health Workers, supported in the discussion about the disputes surrounding their work. Health policy documents were examined, with emphasis on the inflections produced on their attributions and professional training. It was sought to comprehend the rationality and the arguments that sustain the changes induced by the policies and their possible results on the practices. It was identified that this work has assumed conformations increasingly close to health education in a biomedical aspect, aggravated by management mechanisms that promote its fragmentation and simplification. There was no progress in the implementation of the Technical Course of Community Health Worker and, in parallel, short qualifications have been introduced and driven by specific demands. It is understood that the policies directed to this worker are guided by a short-term perspective and express, in the current Brazilian context, the very weakening of the Unified Health System. It is observed the reduction of the role of the Community Health Worker in the consolidation of strategies that could contribute to implement Primary Health Care as a space for strengthening universality and integrality.