EVOLUTION OF PRIMARY HEALTH CARE FUNDING MODELS IN BRAZIL: FROM THE LOGIC OF PREVINE BRASIL TO THE NEW FEDERAL FUNDING MODEL

Abstract

Primary Health Care is recognized as a structuring element of the Unified Health System, being fundamental for the organization of care networks, rationalization of the use of public resources and improvement of health outcomes. Its effectiveness depends, to a large extent, on the funding model adopted, since the criteria for federal transfers influence the provision of services, the organization of work processes and municipal management strategies. Objective: This study aimed to analyze the evolution of co-financing models for Primary Health Care in Brazil, with emphasis on the transition from the Previne Brasil Program to the new federal funding model instituted in 2024. Methods: This is a narrative literature review, of a qualitative and descriptive nature, with a search in the SciELO and LILACS databases for articles published in the last five years. Results: Thirty-one studies were selected that address conceptual, analytical and management aspects of Primary Health Care funding. The results show that Previne Brasil introduced weighted capitation, pay-for-performance and strategic incentives, promoting an increase in population registration and monitoring of indicators, but also revealing regional inequalities and difficulties in municipalities with lower administrative capacity. The new 2024 model, although still little studied, emphasizes equity, territorial linkage and quality of care, seeking to overcome limitations of the previous model. Conclusions: It is concluded that understanding the trajectory of Primary Health Care funding in Brazil is essential for municipal management and to strengthen the sustainability, equity and comprehensiveness of primary care in Brazil.