As diretrizes do Sistema Ãnico de SaÃde apresentam o municÃpio como unidade administrativa bÃsica de sua operacionalizaÃÃo. A SecretÃria de SaÃde do MunicÃpio de Fortaleza vem, desde 1984, direcionando a organizaÃÃo dos seus serviÃos de saÃde em Distritos SanitÃrios na perspectiva do Sistema Ãnico de SaÃde. No perÃodo compreendido entre os anos de 1983 e 1994 ocorreram avanÃos na organizaÃÃo e municipalizaÃÃo dos serviÃos de saÃde desse municÃpio. A anÃlise da evoluÃÃo organizacional da Secretaria de SaÃde do MunicÃpio de Fortaleza, com Ãnfase nesse perÃodo, tem como base leis, decretos, planos de governo, relatÃrios de atividades e entrevistas com os SecretÃrios Municipais de SaÃde. A pesquisa està estruturada em trÃs capÃtulos: retrospectiva das polÃticas de saÃde no Brasil desde o inÃcio do sÃculo atà a atualidade para contextualizar a anÃlise; evoluÃÃo organizacional dessa Secretaria desde a sua criaÃÃo atà o ano de 1983 como referÃncia para o perÃodo em estudo; anÃlise da evoluÃÃo organizacional do perÃodo 1983/1994; e consideraÃÃes sobre os avanÃos organizacionais da InstituiÃÃo. / The guidelines and policies of the BASIC HEALTH SYSTEM in Brazil, introduces each county as na administrative UNIT, which also represents the basis for the implementation and operational functioning of the system itself. Since 1984, the Cityâs Health Department in Fortaleza, Brazil, has been directing the organization of all health services oftered according to the model of the BASIC HEALTH SYSTEM, and there fore administening the delivery of seervices on the basis of HEALTH DISTRICTS. In the period between the years of 1983 and 1984, significant advancements have occured, in the organization and process of local public health service delivery, adjusting to the model of BASIC HEALTH UNITS. The present paper, analyzes the organizational development of the local public Health Department, os the city of Fortaleza, focusing on the above mentioned period, and based upon laws, local government plans and policies, published annual health department activities reports, and interviews with local Secretary of Health officials. This research report is structured is there major chapters: 1) a retrospective survey on major public health policies and political plans, adopted in Brasil, since the beginning of this century, to set up the bacground for the present analysis 2) the organizational development, of the local Healt Department in Fortaleza, since its onset up to the year of 1983, as a reference to the period focused on this study 3) the analysis of the organizational development observed within the period from 1983 to 1994. Finally, some conclusive considerations are made, on the major organizational advancements in this public institution.