Experiências de abordagem comunitária na atenção primária à saúde no Estado do Rio de Janeiro: uma análise à luz da educação popular em saúde e do cuidado emancipatório

Abstract

This study examined community-based interventions implemented within Primary Health Care (PHC) in the state of Rio de Janeiro between 2015 and 2025, analyzing them through the frameworks of Popular Health Education (PHE) and emancipatory care. A scoping review was conducted using the BVS and BDTD-UERJ databases, identifying 17 publications describing territorial initiatives predominantly structured as group activities, educational sessions, waiting-room interventions, campaigns, and workshops. Findings indicate that, despite the presence of some participatory strategies, a predominantly deposit-based and behaviorist political-pedagogical model prevails, characterized by vertical information delivery, limited community engagement in agenda-setting, and strong alignment with managerial imperatives and performance indicators. These patterns suggest that community-oriented actions are frequently shaped by technicist and biologicist professional training, constraining their potential to foster critical participation, collective agency, and context-sensitive health practices. Such limitations are further reinforced by the institutional capture of PHC by productivity-driven management models and by the erosion of territorial work due to increasing assistential demands. Strengthening community-based approaches therefore requires redefining their practical purpose, expanding community participation, investing in critical-reflective professional development, ensuring protected time for territorial engagement, and recognizing care as an inherently political practice. By advancing these dimensions, PHC can reaffirm its role in promoting autonomy, citizenship, and social transformation, in alignment with the ethical and political principles underpinning Brazil’s Unified Health System (SUS).