The historical trajectory of the city of Rio de Janeiroa??s health system: 1916-2015. One hundred years of innovations and achievements

摘要

By rebuilding the history of the facilities that constituted the city of Rio de Janeiroa??s health system between 1916 and 2015, this article also pieces together one hundred years of the countrya??s public health system. Due to its important role, first as the countrya??s capital, then as a state, and later as the capital city of the State of Rio de Janeiro, this city had a major influence on the multiple events that led to the creation of Brazila??s Unified Health System. Periodization was used as a methodological resource to explore how factors that influenced the aims of the technical powers and government were turned into health services stemming from the ideology that underpinned the history of the health system. It is also evident that, despite its constant growth up to the creation of the Unified Health System, the network has always operated in parallel to, and independently from, the hospital and ambulatory network of the social security system and private and philanthropic services. The public health system in Brazil has always been focused at addressing problems related to inequality and social exclusion. The city of Rio de Janeiroa??s primary care network has always played, and continues to play, an important role in disseminating a new organizational culture in Brazila??s national health system .