This study aimed to understand the appropriation of Permanent Health Education (PHE) by Primary Health Care (PHC) in Brazil, through an integrative review of the literature. There was a search for texts published in Portuguese, English and Spanish on PHE in PHC in Brazil, between 2007 and 2017, which addressed the concept of PHE, initiatives developed in PHC and/or perception about changes in professional practice. Twenty-seven studies were selected. The thematic content analysis identified four empirical categories: conceptions of PHE; PHE initiatives and their characteristics in the PHC; positive points and facilitators related to PHE initiatives in PHC; and fragile and difficult points. It was observed that the understanding of PHE by health professionals and managers is close to the concept of Continuing Education (CE). Among the PHE initiatives in the services were: development of technological resources; teaching-service approach; and the formation of collective spaces of meaningful learning in the daily work. However, the devaluation of PHE initiatives contributes to its non-effectiveness in PHC and the valuation of CE practices. It is considered necessary to legitimize PHE as a movement and educational policy in the scenario of PHC in Brazil, aiming at improving the quality of management and care. KEYWORDSPermanent education. Health policy. Primary Health Care. Health human resource training RESUMO Este estudo objetivou compreender a apropriação da Educação Permanente em Saúde (EPS) pela Atenção Primária em Saúde (APS) no Brasil, por meio de uma revisão integrativa da literatura. Buscaram-se textos publicados em português, inglês e espanhol sobre a EPS na APS no Brasil, entre 2007 e 2017, que abordassem o conceito de EPS, iniciativas desenvolvidas na APS e/ ou a percepção sobre mudanças na prática profissional. Foram selecionados 27 estudos. A análise de conteúdo temática identificou quatro categorias empíricas: concepções de EPS; iniciativas de EPS e suas características na APS; pontos positivos e facilitadores relacionados com as iniciativas de EPS na APS; e os pontos frágeis e dificultadores. Observou-se que a compreensão de EPS por profissionais de saúde e gestores aproxima-se do conceito de Educação Continuada (EC). Entre as iniciativas de EPS nos serviços, estavam: desenvolvimento de recursos tecnológicos; aproximação ensino-serviço; e formação de espaços coletivos de aprendizagem significativa no cotidiano do SAÚDE DEBATE | RIO DE JANEIRO, V. 43, N. 120, P. 223-

Background A qualitative and exploratory study that analyzed the perspective of access to Integrative and Complementary Practices in Health (PICS) by listening users from a selected service of primary care of a municipality. Objective Analyze the access to PICS in a health public service of a municipality in a state of Brazil, from the perspective of users, as well as aimed at understand the needs and desires of health care these users in the search process and use of PICS, identifying facilitators and barriers in this trajectory. Methods The theoretical reference from Frenk on access was used, which systematizes the flow of events at the moment when the health need is perceived until the effectiveness of the care, besides the demand and entrance in the health services and the continuity of the treatment. The data collection was done by participant observation and semi-structured interview with 29 users of the service. The narratives were worked through the analysis of thematic content. Results The results indicated two groups of PICS: complex medical systems and therapeutic resources. There were differences in the organization of the offer with consequent influence on the different forms of access. It was registered the interest for the use of health care in a non-biomedical logic and a re-signification of the health-disease process in PICS users, contributing to the continuity of health production. Conclusions It was concluded that the current models of access analysis do not contemplate the diversities of access to the PICS, and the various possibilities of encounters with these practices allow the identification of the marginality of this care in all cases analyzed. Key messages Integrative and Complementary Health Practices gain national relevance as they contribute to the development of health promoting activities, focus on the individual, prevention and comprehensive care. However, considered a controversial topic in a hegemonically biomedical scenario, the incorporation of these new knowledge and practices in the health field occurs in a marginal way.