Table 4. Main characteristics of phytotherapy actions and program consolidated in Brazilian primary health care, 1990-2013.

Location	Basic characteristics of the phytotherapy actions and programs consolidated in primary health care
Amapá, APd	Reference Center for natural treatment; introduces greater diversity of Integrative and Complementary Practices in Brazil; institutionalized by state law 10,068/2007. The experience is based on cultural diversity, including indigenous, of the state of Amapá, and also on the biodiversity of the Amazon Rainforest. Interculturality is the background that guides the work practices developed in partnership with midwives, river dwellers and indigenous healers.
Betim, MG17	Appeared due to the need to seek alternatives to control the high cost of medicines and their side effects. As well as increasing interest and need to guide users in the correct use of plant medicine. The program was in partnership with public and private networks in the municipality: Serviço Assistencial Salão do Encontro , Agriculture Secretariat, Environmental Secretariat, Health Surveillance. The inter-disciplinary team was formed of an agronomist, a pharmacist, an agricultural technician, a doctor, nurse, social worker, dentist, community health agents and a physiotherapist.
Campinas, SP27	In Campinas, phytotherapy was implemented through establishing a Farmácia de Manipulação Botica da Família established by municipal ordinance 13/2001, based on prior history of primary health care initiatives in the municipality. The aim was to respect knowledge, customs and practices, providing education to broaden local culture and stimulate correct use of medicinal plants.
Cuiabá, MTc	The practices of cultivating medicinal and herbal plants in Cuiabá take place through the Phytotherapy, Medicinal and Herbal Plant Program, created in July 2004 and regulated by Decree 4,188/2004 by the Cuiabá Health Secretariat in Mato Grosso. The program aims to guarantee access to the rational use of medicinal plants and phytotherapeutic medicines safely and efficaciously and with quality, contributing to the development of this sector in Brazil. Medicinal plant gardens were established in health care units and treatment homes and phytotherapy medicines are distributed through the health care network, community education activities, training for professionals, identifying plants and producing publicity material to promote the program and praise awareness among professionals.
Curitiba, PR16	This was the result of an intersectoral and multi-professional project created in 1997 with the aim of providing medicinal plants with botanical identification and scientifically tested for use in medical and dental prescriptions. Moreover, stimulating the use of medicinal plants in the community followed the recommendations of environmental education. The program was incentivized by the Municipal Environmental Secretariat, which coordinated the Integration Program for children and adolescents in partnership with the Universidade Federal do Paraná and the State Universities of Maringá and Ponta Grossa. The partnerships with the universities contributed to training the pharmacists of the future and stimulated the development of the national pharmaceutical industry in the region.
Florianópolis, SC41	Permanent educational actions regarding medicinal plants in Florianópolis/SC were established in six health care units in 2012. The phytotherapy-related actions were supported by the Didactic Garden of Medicinal Plants of the Hospital Universitário da Universidade Federal de Santa Catarina and by other local associations. The actions that were developed were: workshop for recognizing medicinal plants aimed at community health agents, didactic gardens in primary health care units, permanent education activities on medicinal plants for doctors, dentists, nurses and pharmacists and creating a municipal treatment memorandum. In the Sul de Ilha health care center, the use of medicinal plants is part of the local community culture, a factor that motivates the professionals to become qualified in this area. The phytotherapy workshop by the Associação Vida Verde Florianópolis/SC , created 28 June 1996, was an initiative of the health department of the Paróquia São Francisco Xavier, in Saco Grande II, Florianópolis/SC, in partnership with women in the community (willing to study, produce and distribute phytotherapy products) and the Universidade do Sul de Santa Catarina . The main aim was to spread solidarity in the community, rescuing popular knowledge of medicinal plants and to integrate knowledge in order to improve quality of life.
Fortaleza, CE24	The oldest experience in Brazil, influencing the creation of actions/programs regarding medicinal plants and phytotherapy in primary health care. The project was called Farmácias Vivas . It was created by Francisco José de Abreu Matos of the Universidade Federal do Ceará , in 1984, with the aim of developing methodology of interaction between popular knowledge and science based on a social approach to guide use of medicinal plants based on botanical identification and to create a reference of phytotherapy pharmaceutical formulas accessible to the population of the Northeast. The Farmácias Vivas project includes a set of actions: ethno-botanical field survey or bibliographical research, recording and validating medicinal plants, collecting plants in the field, training human resources, setting up a Farmácia Viva unit, producing informative material and popular education. Farmácia Viva is a great school and a great example to the world of effective social technology that aids treatment of around 80.0% of common illness in primary care, e.g., skin problems, respiratory and digestive problems, rheumatic pain, intestinal parasites and labial and genital herpes. After its creation in the state of Ceará, it became a national reference for the whole country and for structuring ordinance 886/2010.
Foz do Iguaçu, PR9	The Itaipu herbalist was created in 2005 and contains 18 types of plants to treat 10 common illnesses. In 2007, the first training pf doctors, nurses, pharmacists and dentists took place in partnership with the Instituto Brasileiro de Plantas Medicinais (Brazilian Institute of Medicinal Plants). In order to produce the primary material, 54 agriculturists were trained and established in 17 units to demonstrate the cultivation of medicinal plants and provide technical assistance and rural extension activities.
Goiânia, GOb	The Goiânia Phytotherapy Project was created in 1986 through an agreement between the Goiás Health Secretariat, the Ministry of Health and the Instituto Brasileiro de Ciência e Tecnologia Maharishi . In Goiânia, Ayurvedic phytotherapy was used. In 1987 an outpatient service was established, with a small phytotherpay laboratory. In 1988, the Ayurvedic Phytotherapy Outpatient clinic was transferred to a wing of the former Hospital Juscelino Kubitschek . The Hospital de Medicina Alternativa is recognized throughout Brazil and internationally as a reference for integrated public health practices. The hospital cultivates around 60 species of medicinal plants in its garden to prepare phytotherapies and to preserve them.
Itajaí, SC20	In Itajaí/SC, the insertion of medicinal plants was an initiative of the arterial hypertension control program in partnership with the extension project by the Universidade do Vale do Itajaí , named the university extension in family health project, covering professors and students of speech therapy, psychology, dentistry, medicine, nursing, nursing and pharmacy courses. The program encourages solidarity, exchanging experiences, linking the individual with life and with the health care team, the social group and humanization.
Itapipoca, CE10	Begun in 1999, with the support of the Municipal Health Secretariat, the Universidade Federal do Ceará , the Fundação Cearense de Pesquisa e Célula de Fitoterapia do Estado do Ceará , social reform support program, with the aim of incentivizing women (who use medicinal plants) to make homemade remedies so as to improve their families health and quality of life, based on botanically identified plants and scientific evidence.
Juiz de Fora, MGf	In partnership with the Universidade Federal de Juiz de Fora , the Society for improving neighborhoods, children, family and health departments, community associations. The aim of this program was to recover popular knowledge and raise awareness of the correct use of medicinal plants in popular medicine. To do this, it was decided to follow regional medicinal plant based medicine, as well as experimental and scientific proof of therapeutic effects.
Londrinas, PR4,12	Established in 1996. The aim was to establish a dialogue between two culturally different universes: popular knowledge and biomedicine. The backdrop to these discussions was the humanization of popular practices and of universal health care in the official services. The project counted on the partnership of care and educational institutions and resulted in the construction of a plant medicine unit in partnership with a variety of local institutions. The program had therapeutic gardens and six industrialized phytotherapies, three of which were psychiatric remedies, aiming to de-medicinalize psychotropic users.
Maracanaú, CE42	Begin in 1992. Its basic structure was composed of a garden with four plots for cultivating medicinal plants and a laboratory of manipulation. The program dispenses phytoterapy medicines to the community through prescriptions from a family health care strategy health care professional.
Maringá, PR36	Officially established in September 2000. The program is supported by the Universidade Estadual de Maringá . It is a pharmacy, following the format established in Resolution 33/2,000 with the aim of providing the population with safe, effective and cheap treatment alternatives.
Pereiro, CEe	Begun in 1995 with the establishment of a medicinal plant garden in which there is a technician with medicinal plant knowledge. In 1997, a bio-chemical pharmacist and an agronomist were contracted and the project was broadened according to the instructions of the Farmácia Viva in Ceará. A memorandum was drawn up and a phytotherapy guide. The aim of the project was to meet the population’s needs, taking into consideration cost-benefit and user satisfaction with the treatment response. Phytotherapy medicines were distributed in primary health units, dispensed by the municipal pharmacy in the hospital. The project was supported by the Universidade Federal do Ceará , the Centro Estadual de Fitoterapia (Fortaleza, CE), municipal prefectures, health secretariats and hospitals and health centers.
Pindamonhangaba, SP37	136 discussions on medicinal plants took place between 1992 and 2010, with 3,626 participants. The municipality provided didactic gardens and phytotherapy medicines. The actions were coordinated by the municipality’s Secretariat of Social Assistance.
Presidente Castello Branco, SCa	The aim of the project was to have plant nurseries of vegetable species in home gardens, in schools and in primary care units in the municipality. The initiative was linked to the “ Programa Castellense de coleta seletiva de lixo ”, waste collection program that was a multisectoral project (with municipal administration) linking all of the secretariats and carrying out actions aiming at sustainability, recycling waste, producing organic fertilizer and municipal development. In 2013, the municipality began permanent education actions on medicinal plants for health care professionals, linking educational, health and agricultural workers. It is considered a pioneering intersectorial initiative to insert phytptherapy in the east of Santa Catarina state.
Quatro Varas, CE11	Established in 1988 by Airton Barreto. The aim of the project was to reduce use of psychotropic medicines in cases suffering from panic attacks and to defend the human rights of inhabitants of the Pirambú favela. Moreover, it sought to synthesize popular and biomedical actions intervening in health determinants.
Recife, CE43	Phytotherapy actions in Recife are developed in a center supporting integrative practices and in primary health care units. The actions are guided on the theoretical reference model of defending life and the Paidéia method, (Co-management of collectives, Extended Clinic, Home, Singular Therapeutic Projects and Matrix Support)
Ribeirao Preto, SP31,37	Established in 1992 and regulated by municipal law 8,778/2000 supported by the Sao Paulo state Health Secretariat, the Municipal health conferential and the municipal health council. The municipality had a forest garden, a formula manipulation laboratory, Farmácia Viva in schools, crèches, health care units and community bodies together with family health strategy teams.
Rio de Janeiro, RJ29,39	Stimulated by the Programa Estadual de Plantas Medicinais regulated by state law 2,537/1996. It sought to establish public policies in the area of preservation, research and use of medicinal plants. Moreover, the program provided interaction with other public health programs, sectors and services of the health secretariat and other secretariats in the prefecture in Paquetá, working in the Pedro Bruno municipal school garden, where interaction took place between adolescents and the elderly.
Sao Paulo, SP37	The program to produce phytotherapy and medicinal plants was created by municipal law 14,903/2009 and regulated by municipal decree 51,435/2010 instituting the municipal program of phytotherapy and medicinal plant production in the city of Sao Paulo. The city of Sao Paulo has a municipal health secretariat executive group and a coordinator of sub-prefectures, a municipal relation of phytotherapy that conducted a course on medicinal plants in the municipal school of gardening ( Parque Ibirapuera ), in 2011, with 60 places in the fifth year of the course, 4 multiprofessional courses of 30h in cultivating medicinal plants and a phytotherapy action day in June 2011.
Vila Velha, ES23	Home phytotherapy pharmacy developed by the health department based on solidarity. What the health department did was to establish a counterweight to devices and mechanisms of power that configure the health field, creating new possibilities to constitute citizens’ rights.
Vitória, ES23,41	Established in 1996, by law 4,352. The most notable initiative was the “ Cultivando Saúde: Horta em Casas ” project, which aimed to prevent disease by establishing gardens in wasteland.

^aAntonio GD. Fitoterapia na Atenção Primária à Saúde: interação de diferentes saberes e práticas de cuidado [thesis]. Florianópolis: Centro de Ciências da Saúde da Universidade Federal de Santa Catarina; 2013.

^bBarbosa MA, Baptista SS. A fitoterapia como prática de saúde: o caso do hospital de terapia ayurvedica de Goiânia. Rio de Janeiro: Escola de Enfermagem Anna Nery da UFRJ; 1990.

^cBieski IGC. Plantas medicinais aromáticas no Sistema Único de Saúde da região sul de Cuiabá-MT [monograph of specialization]. Lavras: Departamento de Agricultura da Universidade Federal de Lavras; 2005.

^d Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Práticas integrativas e complementares em saúde: uma realidade no SUS. Rev Bras Saude Fam [Internet]. 2008 [cited 2014 Mar 22];9(Ed. Espec.):3-76. Available from: http://189.28.128.100/dab/docs/publicacoes/revistas/revista_saude_familia18_especial.pdf

^eNegreiros MSC. Uso do medicamento fitoterápico na atenção primária do município de Pereiro-Ceará [monograph of specialization]. Fortaleza: Faculdade de Saúde Pública da Universidade Estadual do Ceará; 2002.

^f Teixeira JBP. Memória institucional da fitoterapia em Juiz de Fora [dissertation]. Rio de Janeiro: Instituto de Medicina Social da UERJ; 2003.