• Priscila Norié de Araujo, Fabiana Ribeiro Santana, Poliana Silva de Oliveira, José Renato Gatto Júnior, Felipe Lima Dos Santos, Karen Silva Santos, and Cinira Magali Fortuna.
• Programa de Posgrado Enfermería en Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil.
• Aten Primaria. 2024 Jan 1; 56 (1): 102780102780.

ObjectiveTo analyze the influences of the institutions in the operation of the Local Health councils.Designqualitative, descriptive and exploratory study.Study Setting02 Primary Health Care services of a municipality in the inland of the state of São Paulo, Brazil.Participantstwenty-four members of the Local Health Councils and 4 key informants.MethodsSupported by the theoretical methodological framework of Institutional Analysis. Data were produced through 28 semi-structured interviews, observation and participation in the activities of the councils and recording in the research diary. Data were organized and analyzed by the process of transcription, transposition and reconstitution.ResultsThe institutions act in the territories represented by social actors who occupy positions and functions within the Primary Health Care services, evidencing the perpetuation of hierarchization with valorization of the speeches of professionals and managers to the detriment of patients and predominance of bureaucratized meetings. The social actors reproduce the ideals of the collective to which they belong in these spaces.ConclusionsThe health management teams do not recognize the different forces that act in the health territory, however, these forces interfere in the activities performed and in health care. The groups act both in formal spaces through official representatives who meet and discuss issues in collegiate meetings and in informal spaces, and constitute forces in dispute in the health territory.Copyright © 2023 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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