National policy on integrative and complementary practices: Trajectory and challenges in 30 years of SUS

Abstract

This article analyzes the construction and development of the National Policy on Integrative and Complementary Practices (NPICP) in SUS and its background. The study involved literature review, documentary analysis, and interviews with key actors in the policy building and implementation process. It was based on Kingdon's multi-flow model with regard to the formulation of the political agenda. The results point to important moments in the policy trajectory: influence of international parameters; role of national health conferences in building social demand; initial experiences of supply in the public network; protagonism in teaching and research; entry into the political agenda; federal leadership and challenges to institutionalization. The formulation of the NPICP is based on the pressure of strategic actors who undertook actions under favorable institutional conditions within the scope of the Ministry of Health after political change within the Federal Government in 2003, creating a window of political opportunity. This process was marked by resistance stemming from biomedical rationality and disputes of interest. Despite advances in the dissemination and visibility of service provision, actions under federal driving were not accompanied by significant changes in the training of professionals and in hegemonic health practices.