Promotion of body practices and physical activities in the Brazilian Unified National Health System: changes in sight, but to which direction?

Abstract

The National Health Promotion Policy is the major milestone in the promotion of body practices and physical activities in the Brazilian Unified National Health System (SUS). After it, different actions and strategies were created, such as the Health Academy Program, the Expanded Family Health and Basic Healthcare Centers (NASF-AB), and the School Health Program 1 .Nowadays, the strengthening of neoliberal policies and fiscal austerity measures are aggravating the underfunding of SUS, with a consequent repercussion on body practices and physical activities actions 2 . Despite this, the creation of a specific organizational structure in the Brazilian Ministry of Health 3 and the release of the Physical Activity Guidelines for the Brazilian Population 4 show that the topic remains on the agenda.Moreover, in May 2022, the Brazilian Ministry of Health released the Physical Activity Incentive, a program that aims to implement body practices and physical activities actions in primary health care (PHC) -by hiring physical education professionals, purchasing consumables, and qualifying body practices and physical activities environments -and improve the care of people with chronic noncommunicable diseases -by introducing body practices and physical activities in their routine 5 . This investment includes different values for each type of health unit and physical education professional hired, with two possibilities of workload (Table 1).Understanding that the Physical Activity Incentive may significantly change the body practices and physical activities promotion "model" in PHC, this text aims to present initial analyses on the Physical Activity Incentive, considering its acting in the SUS management, as well as in the teaching and research of the authors of this text.The technical criteria for prioritizing health units that will receive the Physical Activity Incentive are currently unavailable 5 , but they must aim at equity in the qualification process, so that no unequal access to the resource occur. Health indicators, structuring of the PHC network, size of municipalities, among others, must be part of this prioritization criteria.In case of qualification, municipal programs of corporal practices and physical activities consolidated in the SUS, municipalities that remained with physical education professionals after the extinction of specific funding for the NASF-AB 6 and other initiatives that have these professionals inserted in health units will receive greater amount of resources since they will be able to allocate this professional in qualified health units, except for those who already receive funding resources as similar to the Health Academy Program. However, only one code from the Brazilian Classification of