Building integrality in the primary care network: challenges and strategies for expanded care

Abstract

This study analyzed how the principle of comprehensive care has been constructed and implemented in the Primary Health Care Network (PHC) within the context of the Brazilian Unified Health System (SUS), identifying challenges and strategies to promote comprehensive and effective care. It is an integrative literature review, searching for articles published between 2020 and 2025 in the SciELO, LILACS, and BDENF databases. The descriptors "Primary Health Care," "Comprehensive Care," and "Family Health Strategy" were used, combined with the Boolean operator AND. Articles in Portuguese, available in full text, were included, excluding duplicates and those outside the thematic scope. Critical evaluation and interpretation of the results were performed. The final sample consisted of nine articles with different methodological approaches, predominantly qualitative studies (55.56%), mainly developed in the states of São Paulo and Rio Grande do Sul. The findings highlight multiple approaches to comprehensiveness in different contexts and populations, emphasizing the complexity, scope, and centrality of this principle in consolidating more humanized and integrated practices in primary health care. Comprehensiveness has been strengthened through practices based on welcoming, qualified listening, and interprofessional work, with emphasis on the role of nurses in coordinating care and promoting educational and intersectoral actions. Among the main challenges are the fragmentation of actions, the overload of teams, and the limited articulation between levels of health care.