Liderazgo y gestión estratégica en sistemas de salud basados en atención primaria de salud

OBJECTIVES. To identify and analyze various types of leadership and management that could contribute to the strengthening of health systems based on primary health care (PHC). METHODS. A structured review of the literature on management and leadership applicable to PHC-based health systems was conducted. Of the 19 articles identified, relevant details were extracted using a standardized methodology. RESULTS. PHC-based health systems should establish optimal management practices to achieve quality, efficiency, and effectiveness. Strategic planning and management facilitate the development of a common identity, although some organizations are overmanaged and poorly led. Universal health is a strategic driver that requires transformational leadership to move toward PHC-based systems. Leadership in these systems must focus on identifying adaptive challenges, linking staff and protecting grassroots leadership, as well as adapting to the times and combining the logic of action of the strategist to achieve a sector transformation. The quality models establish leadership criteria similar to other theories, emphasizing innovation and organizational identity. CONCLUSIONS. Latin America must move towards health systems based on PHC, with leaders with emotional intelligence who discover their own transformative events, seek quality, and combine various types of leadership. They must be strategists to lead the system in its transition to resilient organizations, and “alchemists” to achieve true transformations in health, with the willingness and humility of those who work to achieve universal health.