Accessibility is the relationship between health services and users in which both contain in themselves the ability or inability to meet. Considering health as a fundamental right, there is a need to understand the dynamics of the elements involved in access to health care(such as inequalities and health equity, the vulnerability of certain groups, the determinants of their health and the dimensions of access to services)and determine the role of management in order to improve access. The crucial aspects that have been identified: the availability of evidence on inequality in access, effective local leadership, identification of appropriate intervention, monitoring and evaluation of management and impact and the identification of additional resources to help eliminate exclusion. It is concluded that to achieve improvements in access, it is necessary to understand that those who provide direct care to users and the patients them selves are key elements to consider in the dynamics of care, and this in turn requires the commitment of health authorities that consider the right to health as a crosscutting issue of interventions to increase access to services

Accessibility; right to health; health determinants; health managem