Objective: Reflect on the gaps in the care of Children with Special Needs in Health that demand complex clinical care with dependence on technological support for the maintenance of life, in the Unified Health System. Methods: This is a reflection study based on recent policies and literature related to the theme. Discussion: Despite the advances achieved with the Unified Health System with regard to access to health services and the expansion of Primary Care, with the aim of reorienting health, it can be said that the health care model for CSHCN in Brazil is still centered on the hospital and medical knowledge. Final considerations: There are gaps in the policies for children aimed at the new paediatric profile, and little is discussed about its implications for the Unified Health System.
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