Genetics in primary health care and the National Policy on Comprehensive Care for People with Rare Diseases in Brazil: opportunities and challenges for professional education

This article aims to highlight the discussions on the National Policy for Comprehensive Care in Clinical Genetics and reflect on its pending regulation when genomic discoveries change the model of health care. Nine of the ten causes of morbidity and mortality worldwide presents genetic/genomic predisposition. Based on strategic planning, this Policy proposes the organization of a network of referral services and specialized centers in genetics, with capacity to meet the needs of the population. Its regulation requires training and qualification of the health care professionals to provide comprehensive care, to optimize access, to identify and diagnose individuals with increased risk for injuries with genetic predisposition early. In primary health care, the care in question should not be interpreted as a specialty, but as specialized. This model presents innovative perspectives, in line with the principles and guidelines of the Unified Health System.

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Is vaccination against hepatitis B a reality among Primary Health Care workers?

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692013000100005 ◽

2013 ◽

Vol 21 (1) ◽

pp. 316-324 ◽

Cited By ~ 3

Author(s):

Fernanda Marques da Costa ◽

Andréa Maria Eleutério de Barros Lima Martins ◽

Pedro Eleutério dos Santos Neto ◽

Duran Nunes de Pinho Veloso ◽

Vilma Soares Magalhães ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Hepatitis B ◽

Occupational Health ◽

Health Care Workers ◽

Professional Education ◽

Older Workers ◽

Primary Health ◽

Vaccination Scheme ◽

Care Workers

OBJECTIVE: To verify the prevalence and factors associated with vaccination against hepatitis B among Primary Health Care workers in Montes Claros/MG. METHOD: A cross-sectional, analytic study was undertaken. Data were collected through a form, which contained sociodemographic, occupational, general health and behavioral variables. Associations were investigated through bivariate analysis and Poisson's multivariate regression, using SPSS 17.0. RESULTS: 95.5% answered the question about vaccination; 47.5% did not complete the vaccination scheme. The prevalence of vaccinated professionals was lower among older workers, who were hired, did not participate in occupational health updates and consumed alcohol. Prevalence levels were higher among professionals with more years of education and who reported contact with piercing and cutting instruments . CONCLUSIONS: Professional education, knowledge and perception of infection risks are important determinants of the vaccination scheme. Instability at work may lead to negligence and negligent behaviors may repeat themselves. The characterization of professionals who did not get vaccinated will direct educative actions in occupational health.

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Access of the LGBTQI+ population from the perspective of community health agents, Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.770 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M H N Souza ◽

A A Pinho ◽

L Graever ◽

A R Pereira ◽

A M S Santana ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Community Health ◽

Quantitative Research ◽

Health Workers ◽

National Policy ◽

Comprehensive Health Care ◽

Care Network ◽

Primary Health ◽

Comprehensive Health

Abstract Introduction In Brazil, according to the National Policy for Integral Health for Lesbians, Gays, Bisexuals, Transvestites, Transsexuals, Queers, Intersexuals and other identities (LGBTQI+), it is increasingly necessary to guarantee access to the health system, as well as to train qualified professionals. Objective describing the perception of Community Health Agents (CHA) about the approach to and access of LGBTQI+ people to primary health care. Methods Quantitative research conducted in October 2019 with 60 community health workers from the municipality of Rio de Janeiro, Brazil. The research was approved by the Ethics and Research Committees of the participating institutions. Results it was found that 100% of the CHA have already supported LGBTQI+ people, 19.2% identify prejudiced attitudes and delay in service as barriers to accessing the unit, and 19.2% recognize the presence of group activities in the unit. In the view of the CHA interviewed, LGBTQI+ patients could be approached in groups (50%), individually (19.2%) or both (30.8%). Among the strategies to increase the access of those patients, 61.5% are unaware and 38.5% listed possible strategies to be implemented in the unit. The topics of interest for discussion were: approach to reception, sexual identity, prejudice, psychological support, family, diseases, violence, and rights. Conclusions From the perspective of community health agents, the study allowed reflections on how approaching and making access available to LGBTQI+ patients in the primary care network. This evidences stigmas and fragility of professionals in the individual and collective approach to deal with issues regarding guidance sexuality and gender identity of the clientele served. It is important to emphasize permanent education actions among professionals, aiming at a comprehensive health care for the LGBTQI+ population. Key messages Welcoming and qualified listening promote comprehensive health care for the LGBTQI+ population. Improvements in the access of the LGBTQI+ population to the primary health care network decrease morbidity and mortality.

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Addressing inequities in access to primary health care: lessons for the training of health care professionals from a regional medical school

Australian Journal of Primary Health ◽

10.1071/py11040 ◽

2011 ◽

Vol 17 (4) ◽

pp. 362 ◽

Cited By ~ 3

Author(s):

Sarah Larkins ◽

Tarun Sen Gupta ◽

Rebecca Evans ◽

Richard Murray ◽

Robyn Preston

Keyword(s):

Health Care ◽

Primary Health Care ◽

Professional Education ◽

Health Care Professionals ◽

Health Care Services ◽

Underserved Populations ◽

Health Sector ◽

Care Services ◽

Primary Health ◽

Primary Health Care Services

Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities.

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Physiotherapy practices in primary health care

Fisioterapia em Movimento ◽

10.1590/fm.2021.34109 ◽

2021 ◽

Vol 34 ◽

Author(s):

Cíntia Raquel Bim ◽

Brígida Gimenez de Carvalho ◽

Celita Salmaso Trelha ◽

Kátia Suely Queiroz Silva Ribeiro ◽

Rossana Staevie Baduy ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Professional Training ◽

Service Management ◽

Family Health ◽

Comprehensive Care ◽

Semistructured Interview ◽

Coverage Area ◽

Primary Health ◽

Care Family

Abstract Introduction: Physiotherapy was included in primary health care (PHC) in order to expand access and provide comprehensive care to the population. Objective: To understand the routine and tools used by physiotherapists in primary health care and analyze the determining factors in providing care in a municipality where every basic health unit (BHU) has a physiotherapist. Methods: This is a qualitative study of nineteen physiotherapists conducted in a city of Southern Brazil, using a semistructured interview and a methodological framework for discourse analysis. Results: The main tools routinely used in the physiotherapy service are individual appointments, home visits and group work. Physiotherapy practices are influenced by public health, municipal management and BHU policies, physiotherapy profile in addition to the characteristics of the coverage area and the population being treated. Introducing health promotion measures and implementing relational technologies are the main challenges for physiotherapists, and many of these professionals already recognize their importance in promoting comprehensive care. Conclusion: Physio-therapy practices and the tools used are in line with the Primary Care Family Health Support Center (NASF-AB) model of action recommended by public policies and have been effective for many health conditions. Knowing the routine of PHC physiotherapy services may help professional training and service management, with a view to producing physiotherapy care aimed at the principle of comprehensiveness and consolidating the role of physiotherapists at this level of care.

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Planning and politics of resource allocation for primary health care: Promotion of meaningful national policy

Social Science & Medicine ◽

10.1016/0277-9536(83)90135-1 ◽

1983 ◽

Vol 17 (24) ◽

pp. 1947-1960 ◽

Cited By ~ 28

Author(s):

Malcolm Segall

Keyword(s):

Health Care ◽

Resource Allocation ◽

Primary Health Care ◽

National Policy ◽

Primary Health

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Effective and meaningful participation or limited participation? A study of South African health committee legislation

Primary Health Care Research & Development ◽

10.1017/s1463423621000323 ◽

2021 ◽

Vol 22 ◽

Author(s):

Hanne Jensen Haricharan ◽

Maria Stuttaford ◽

Leslie London

Keyword(s):

Health Care ◽

Human Rights ◽

Primary Health Care ◽

Health Facility ◽

National Policy ◽

Health Care Facilities ◽

Western Cape ◽

Meaningful Participation ◽

Primary Health ◽

Health Committee

Abstract Background: Health committees are participatory structures providing community input in health systems. Community participation is a critical tenant in the Alma-Ata Declaration and the Right to Health. In South Africa, national and provincial legislation provides for health committees to be established at all primary health care facilities. Aims: This paper aims to analyze whether the Western Cape Health Facility Boards and Committees Act (2016) is likely to result in effective and meaningful participation consistent with a Primary Health Care (PHC) and human rights approach to participation. The paper also explores whether the provincial Act addresses challenges identified in practice. Methods: The methods consist of an analysis of the Western Cape Health Facility Boards and Committees Act, which is then compared to the international PHC and human rights approach to participation. Findings from an explorative mixed-methods study with health committees in Cape Town are used to discuss whether the Act addresses shortcomings identified in practised participation. Findings and analysis: The paper found that the current legislation is unlikely to lead to effective and meaningful participation. First, the roles prescribed in the Act are narrowly defined. They resemble roles practised and are inconsistent with right-based and PHC frameworks. Second, though the Act provides support, which the empirical research demonstrates is necessary, the support is insufficient, and often contingent. Third, the Act conceptualizes health committees as structures appointed by the Provincial Minister of Health; a formation process likely to lead to structures that do not adequately represent community interests. Conclusions: The paper argues that the Western Cape legislation is unlikely to lead to effective and meaningful participation. It suggests using international PHC and human rights frameworks and national policy documents to restructure health committee participation in the Act and the National Health Insurance Bill.

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Professional education on dementias in Primary Health Care: an integrative review

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0652 ◽

2019 ◽

Vol 72 (4) ◽

pp. 1086-1093 ◽

Cited By ~ 1

Author(s):

Gislaine Desani da Costa ◽

Vívian Marina Calixto Damasceno Spineli ◽

Maria Amélia de Campos Oliveira

Keyword(s):

Health Care ◽

Primary Health Care ◽

Professional Education ◽

Health Care Professionals ◽

Health Personnel ◽

European Continent ◽

North American Continent ◽

The North ◽

Primary Health ◽

Mesh Terms

ABSTRACT Objective: To investigate the most commonly used educational approaches in dementia training for primary health care professionals. Method: Integrative literature review, conducted between April and June of 2018, in PubMed, LILACS and IBECS databases. The descriptors used were: Training, Health Personnel, Dementia, Primary Health Care for PubMed; and the MeSH terms, Training Programs, Health Personnel, Dementia, and Primary Health Care for LILACS and IBECS. Results: The sample consisted of 13 articles; eight were published in the last five years (62%); seven articles with a quantitative approach (54%); seven articles produced on the European continent (54%), followed by five published on the North American continent (38%). All journals were from the health area (100%). Conclusion: Educational strategies were combined and used for education. Significant improvements in knowledge, skills, and attitudes of the teams with regard to professional management of dementias were evidenced.

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Professional education in primary health care: experience and challenges in municipalities of Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckw171.077 ◽

2016 ◽

Vol 26 (suppl_1) ◽

Author(s):

GML Pinheiro ◽

JP Bispo Júnior ◽

DC Moreira ◽

IO Chaves ◽

DM Silva ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Professional Education ◽

Care Experience ◽

Health Care Experience ◽

Primary Health

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Abstract P444: Surveillance, Control, and Prevention Systems and Community Engagement Process of Hypertension in Singburi, Thailand

Hypertension ◽

10.1161/hyp.70.suppl_1.p444 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Vichai Tiienthavorn

Keyword(s):

Blood Pressure ◽

Health Care ◽

Primary Health Care ◽

Community Engagement ◽

Best Practice ◽

National Policy ◽

Target Population ◽

Term Operation ◽

Primary Health ◽

Control And Prevention

Background: Recently,the patients of non-communicable diseases are increasing in Thailand; especially hypertension. However,finding high blood pressure early, treating and keeping it in the normal range can reduce the risk of developing complications such as Stemi and Stroke. Thailand has 10 million hypertension patients in 2013. Hence, Thai Government has policy to reduce the NCDs such as hypertension. Methods: This study was to convert disease oriented to health promotion approach to primary health care, using “ VICHAI’s 7 Color Balls Model”, which was used for primary screening of hypertension. The target population aged 15-65 which covering more than 90% of Singburi population. The screening result was classified by types and levels of severity of hypertension (blood pressure).The 7 colors are referred to normal <120/80 mmHg, white, risk 120/80-139/89 mmHg, light green, risk medication <139/89 mmHg, dark green, mild 140/90-159/99 mmHg, yellow, moderate 160/100-179/109 mmHg, orange , severe >180/110 mmHg, red, and patients with complication (black). The normal and risk group measured BP every 3 months, while the patient group did every month. Results: The control and prevention systems were developed to follow up patients using investigation, health education to encourage strictly medication and their behavioral change with best practice of 3Es(Eating,Exercise,Emotion) and 3Rs (Reducing tobacco,alcohol, obesity). Screening Hypertension was coverage 97.41% (2014-2015),normal group (white) increased from 72.55% to 74.94%, Significantly severe patients (red) were decreased to moderate (orange) from 0.11% to 0.07% and the complicated patient with STEMI decreased of 17.14% Furthermore, treatment cost decreased 3.9 million baht. Conclusions: This project is expanding in all provinces of Thailand as it is now one of the priority government policy. And it is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in primary health care. Main Message: Finally, outcome of this study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation.

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