Objective:

To describe the process of implementation of PAIS as perceived by its actors and the territorial particularities of the Department of Cauca.

Materials and methods:

Research from a qualitative perspective adopting the case study and, as a reference, the Subirast analytical model. Fourteen semi-structured interviews were conducted with process leaders, 47 planning documents were reviewed and information was complemented with a field diary.

Results:

The PAIS implementation process allowed progress from some elements of the strategic and operational framework. However, participants experience limitations in the adoption of primary care, the health authority and the articulation of actors. Human talent in health is fundamental in politics. However, its permanence in territory is discontinuous.

Conclusions:

The limited inter-institutional work, the clientelist practices, the weak health authority and the lack of management structures according to PAIS, lead to think about the need to increase capacities and resources to level the understanding and operation of strategies contemplated in the policy. The weakness of the State to make effective regulation, control and surveillance of health actors is emphasized.

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