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Kehrig RT. “Integrality” (comprehensiveness) of health attention: its expressions in the technological organization of the work in health service sites. São Paulo, 2001. [Doutoral Thesis Faculdade de Saúde Pública da USP.] Objective. The idea of “integrality” has been the most important ethical and normative principle of the Brazilian Health System (Sistema Único de Saúde). Nevertheless it has not been well studied. This work tried to identify the organizational conditions required carrying out activities in such a way as to aim municipal health systems to reach the principle. This thesis advocates the management features as a special dimension in reaching effective “integrality”. Bibliographic review. It was done a review of specialized publications on the use of the expression “integrality of health” or any expression with a similar meaning. The main concepts identified were briefly described. The review also described the ideas and practices on comprehensiveness in the recent history of Brazilian health system. Methodology. This is a qualitative research developed in one of the major municipal health secretariats located in the state of Santa Catarina, Brazil. Data was collected through open interviews with health professionals. The professionals were selected in terms of their participation in the movement for changing the working model of health services. They were interviewed using open questions. The analysis of the empirical data was carried out through the construction of a collective discourse, using the appropriate methodological adjustments. Results. The analysis and discussion of the empirical data enabled the organization of seven different ways, which together present the potential for operating “integrality”: health attention centered on a primary care net; political-organization, local-regional management, democracy, learning organizations and pedagogy.

Integralidade da atenção à saúde: suas expressões na organização tecnológica do trabalho em serviços locais de saúde