This study focused on the health needs of a population covered by a primary healthcare center (PHC) in the city of São Paulo, Brazil. The overall objective was to investigate the perceived health needs as the object of health work. The study thus identified and analyzed what residents recognize as health needs, as well as what the PHC workers grasp as the object. The PHC workers and local residents were the research subjects. A semi-structured interview was used for data collection and thematic analysis for grasping the reality. The empirical categories identified were: need for state presence, social reproduction needs, and need for political participation recognized by local residents as health needs. The analysis indicated that the PHC work has operated without recognizing the residents' needs. Overcoming such gaps may be possible if and to the extent that work processes are implemented according to the recognition of health needs, respecting the concept of determination in the health-disease process and the right to health as a political gain.
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