Popular Knowledge of Care

Popular knowledge and traditional practices of care constitute a fundamental cultural and health heritage in the Brazilian context. Rooted in Indigenous, African and European traditions, these knowledge systems articulate spiritual, symbolic, ecological and social dimensions, and are transmitted orally across generations.

Popular care practices in Brazil arise from a historical process of encounter and syncretism among three major cultural matrices: Indigenous, African and European. Indigenous peoples developed sophisticated healing systems grounded in their relationship with nature, the use of medicinal plants, pajelança rituals and a spiritual understanding of illness. African traditions, brought by enslaved peoples, contributed prayers, baths, smudging rituals, the use of roots and leaves, and a cosmology centered on orixás and spiritual entities as mediators of vital balance. European influence introduced rural healing practices, blessings and traditional midwifery, which merged with the other traditions into a hybrid body of community-based practices.

These orally transmitted practices constitute unique forms of interpreting health and illness, understanding the human being as an inseparable unity of body, spirit and nature. Ethnographic studies show that benzedura (healing blessings), for example, involves protective rituals, symbolic gestures and the use of prayers, playing a key role in social cohesion and community spirituality.

Brazilian popular medicine comprises a plural set of care practices and knowledge deeply rooted in rural, riverside, quilombola and urban-peripheral communities. These practices—such as the use of medicinal herbs, prayers, benzeduras, traditional midwifery, baths, herbal tonics and rituals—constitute a form of comprehensive health care that goes beyond biological dimensions and values community bonds, spirituality and territorial belonging.

The relevance of popular knowledge to Brazilian public health is evident both in its social reach and in its alignment with the principles of comprehensiveness, humanization and equity that guide the Unified Health System (SUS). Historically, however, this body of knowledge has been devalued, categorized as folk healing and marginalized by the dominant biomedical model.

Beginning with the 1988 Federal Constitution and the creation of SUS, a new field of dialogue emerged between biomedicine and traditional care systems. Policies such as the National Policy for Health Care of Indigenous Peoples (PNASPI), the National Policy for the Comprehensive Health of the Black Population (PNSIPN) and the National Policy on Popular Education in Health (PNEPS-SUS) began to formally recognize these traditional knowledge systems.

The relationship between popular practices and health services—especially SUS—is marked by both tensions and progress. Reports from different territories show that in Family Health Strategy (ESF) areas, practices such as benzedura and the use of medicinal plants are recognized by communities and, in some cases, interact with formal health services.

Research conducted in ESF territories indicates that the population draws simultaneously on health services and popular practices. In rural and riverside areas, the use of medicinal plants and visits to healers remain primary forms of care. This dual circulation of knowledge demonstrates that health care in Brazil is plural, dynamic and adaptive. However, the dialogue between technical-scientific knowledge and popular knowledge continues to be characterized by tensions, prejudices and hierarchies of power.

Challenges include cultural prejudice, the lack of formal recognition for traditional practices (such as benzedura and traditional midwifery), difficulties in integrating popular knowledge into public policies and the risk of inappropriate appropriation of collective knowledge. Traditional healing and care practices not only expand access and the effectiveness of the health system but also strengthen cultural identity and community bonds.

Popular Education in Health (EPS) emerges as an essential strategy to mediate dialogue between scientific and popular knowledge, valuing community experience and promoting the autonomy of individuals. Inspired by the work of Paulo Freire, EPS recognizes education as a political and transformative process—one that aims at critical consciousness and social transformation. Freire conceived education as a dialogical and liberating practice, based on problematizing reality and fostering conscientização—the process through which individuals become active subjects in their own history and health.

In primary health care services, EPS is expressed through practices such as discussion circles, community workshops, collective initiatives and self-care groups. These spaces enable exchanges between professionals and users, overcoming hierarchical relationships and strengthening therapeutic bonds.

Individual and collective autonomy in care is a central principle of both popular knowledge and EPS. In contrast to the biomedical model centered on prescription and control, popular practices seek to empower individuals and communities in the process of caring for themselves and others.

The principle of comprehensiveness in SUS can only be fully achieved when cultural, spiritual and territorial dimensions of health are incorporated. From this perspective, the encounter between popular and scientific knowledge is a political and pedagogical act—not a mere combination of practices, but a shared reconstruction of meanings and responsibilities.

Despite advances, challenges remain. Gaps persist in formal recognition of traditional practices linked to traditional communities, such as benzedura and traditional midwifery, as well as in mechanisms for documenting and protecting collective knowledge from commercial exploitation. Cultural prejudice and inequities in access also continue to hinder the full integration of these knowledge systems into the SUS network.

In the current context, strengthening traditional knowledge requires policies that promote its value, the training of health professionals open to intercultural dialogue and mechanisms that protect the collective rights of knowledge-holding communities. Integrating popular knowledge into the health services can increase the effectiveness of SUS while respecting cultural diversity and ensuring more humane, comprehensive and territory-based care.