Health promotion within primary health care: a study of evaluability in focus

Abstract

This is an evaluability study of health promotion within the scope of Primary Health Care (PHC), partially based on the methodology proposed by Thurston and Ramaliu. The process resulted in the construction of a Theoretical Model (TM) and a Logic Model (LM), both validated through two rounds of consensus workshops with ten experts in the fields of health evaluation and health promotion. The TM and a LM highlight the core components of health promotion, structured around the dimensions of structure, management, care, and education and communication. The study also enabled a critical reflection on terms such as “empowerment” and “social control”, proposing conceptual reformulations that emphasize more democratic and collective approaches, such as “an engaged, committed, and autonomous population” and “democratic participation and governance.” Despite the challenges faced by PHC, its transformative potential is recognized, especially when supported by intersectoral actions, social participation, and continuous education. It is concluded that health promotion should be consolidated as a structuring axis of PHC, requiring investments in processes, infrastructure, and intersectoral coordination that strengthen territories as active spaces for health promotion.