In Brazil, access to health care is a universal
social right guaranteed by the government
since 1988 through the Unified Health System
(Sistema U´nico de Sau´de).4 The Unified Health
System is a decentralized system, and the organization
and delivery of health care is the responsibility
of municipal authorities with financial
and technical support provided by state and
federal governments. The local government organizes
the physical structure, equipment, and
professional teams to provide the population
with access to health services. The goal is to
invest in strong primary health care, and to this
end an optional alternative model, the Family
Health Strategy (FHS), was developed during the
1990s.4,5 The FHS has subsequently been
adopted by many municipalities in Brazil and
has replaced the Traditional Primary Health
Care (TPHC) system in many areas. TPHC
was introduced in the Brazilian public system
during the1980s, after the Alma-Ata Declaration
in 1978 identified primary health care as the
key to the attainment of the goal of Health for
All.