Este estudio parte de la premisa de que en los servicios de salud primaria en Chile, predomina la utilización de enfoques conservadores de tipo estructural normativo de las familias, que difieren de la variedad de formas familiares contemporáneas y que no dan cuenta de las transformaciones que éstas han experimentado. Para responder este supuesto, se exploraron los enfoques teóricos sobre las familias declarados en la política de salud que guían el accionar de los implementadores, y se describieron y analizaron las diversas comprensiones sobre ellas, que tienen los funcionarios de los servicios estudiados. Se realizó un estudio de caso en cuatro centros de salud primaria de la región del Maule, Chile, durante el año 2010. Se aplicaron 11 entrevi stas semi-estructuradas y 6 observaciones no participantes, las que fueron analizadas a través del método de comparación constante. Posteriormente se desarrolló el modelo teórico y se analizaron sus implicancias. Los resultados evidenciaron que la política de salud pública, se caracteriza por promover marcos conceptuales sobre las familias, tradicionales y homogenizantes que no se ajustan a su realidad. Además, se constató que la mayoría de los sujetos de estudio poseía una mirada conservadora y tradicional sobre la misma, producto del peso de esta agenda política y de la alta influencia de los enfoques estructurales en la sciencias de la salud.This study starts with the premise that in the primary health services in Chile, there is a preponderance of the use of conservative approaches towards the normative structural family type, which is at variance with the range of contemporary family structures and which does not reflect the transformations that families have undergone. In order to respond to this premise, the theoretical approaches with regard to families set forth in the health policies which guide the actions of those who implement the said policy were explored, and the various ways in which the public officials who deliver the services under examination interpret them were described. A case study was carried out at four primary health clinics in the region of Maule (Chile), during 2010. Eleven semi-structured interviews and six non-participating observations were carried out, which were then analysed using the constant-comparison method. Subsequently the theoretical model was developed and its implications were examined. The results revealed that the public health policy is characterized by the promotion of traditional and standardized conceptual frameworks with regard to families, which do not reflect reality. Furthermore, it was found that the majority of the subjects studied had a conservative and traditional outlook with regard to the family, deriving from the weight of this political agenda and from the significant influence of the structural approaches in health science.