Black women’s health and Primary Health Care: between the coloniality of care, everyday struggles, and confronting racism

Abstract

This essay, as a result of accumulated research, lived experiences, and critical reflections, analyzes the construction of the social place of Black women, particularly within Primary Health Care (PHC), highlighting how racism, sexism, and class and territorial inequalities contribute to the production of vulnerabilities. Using intersectionality as a theoreticalpolitical tool and a critique of the coloniality of care, the text demonstrates how the universalist logic—based on supposed neutrality—and an insufficiently developed approach to racial equity render the vulnerabilities of these women invisible, along with the impacts on their living conditions, especially in contexts such as the streets, favelas, and incarceration. It questions the effectiveness of approaches that, by failing to consider the multiple layers of oppression, reinforce stereotypes and contribute to the perpetuation of social disadvantages. The essay emphasizes the leadership of Black women in denouncing institutional racism and in creating collective and ancestral care technologies. It underscores the urgency of articulating and mainstreaming public policies, with emphasis on the National Policy for the Comprehensive Health of the Black Population and the National Policy for the Comprehensive Health of Lesbians, Gays, Bisexuals, Transvestites, and Transsexuals, highlighting significant ongoing initiatives. It concludes that equitable care requires confronting racism within PHC practices, grounded in Black feminist epistemologies and the valorization of reexistence experiences within the territories.