Participatory management in primary health care and the role of nurses in the collective construction of public policies

Abstract

Objective: To analyze, through an integrative literature review, the scientific evidence on the role of nurses in participatory management within Primary Health Care (PHC), with emphasis on their involvement in the collective construction of public health policies. Methods: Integrative literature review conducted in databases such as PubMed, Scopus, Web of Science, CINAHL, and LILACS. A total of 18 studies published in recent years were included. Data analysis was performed using thematic analysis according to Bardin. Results: Three categories were identified: nurses’ participation in decision-making processes; structural, organizational, and educational determinants; and involvement in governance and health policies. Findings indicate that participation is influenced by institutional support, political training, organizational culture, and working conditions. Advances in nurses’ participation in organizational settings were observed; however, limitations persist due to hierarchical structures and unequal power distribution among health professions. Final considerations: Nurses play a strategic role in participatory management in PHC, although their involvement in broader policy-making remains limited. Limitations include study heterogeneity, temporal and language restrictions, and potential bias. Future research should focus on implementation science, cost-effectiveness, and equity.