scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals Presence and extent of the primary health care attributes among children hospitalized for pneumonia

2015 ◽  
Vol 23 (3) ◽  
pp. 512-519 ◽  
Author(s):  
Juliana Coelho Pina ◽  
Suzana Alves de Moraes ◽  
Maria Cândida de Carvalho Furtado ◽  
Débora Falleiros de Mello
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Family Counseling ◽  
Coordination Of Care ◽  
Access To Health Services ◽  
Unified Health System ◽  
Primary Health ◽  
Access To Health

OBJECTIVE: to analyze the presence and extent of the primary health care attributes among children hospitalized for pneumonia.METHOD: observational and retrospective study with hospital-based case-control design, developed in three hospitals associated to the Brazilian Unified Health System, located in a city of the State of São Paulo, Brazil. The study included 690 children under five years old, with 345 cases and 345 controls.RESULTS: both groups scored high for access to health services. In contrast, high scores for attributes such as longitudinality and coordination of care were observed for the controls. Despite low scores, integrality and family counseling were also high for the controls.CONCLUSION: knowledge of the aspects involving the primary health care attributes and its provision for child care are very important because they have the potential to support professionals and managers of the Brazilian Unified Health System in the organization of health services.

scholarly journals Presence and extension of the attributes of primary health care in public dental services in Porto Alegre, Rio Grande do Sul State, Brazil

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Débora Deus Cardozo ◽  
Juliana Balbinot Hilgert ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Erno Harzheim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Services ◽  
Assessment Tool ◽  
Evaluation Instrument ◽  
Primary Health ◽  
Care Assessment ◽  
Oral Health Services

The objective was to compare the presence and extension of primary health care (PHC) in oral health services using the PHC attributes according to three different types of PHC organizational arrangements: Family Health Strategy (FHS), Community Health Service (CHS) and Traditional Primary Care (TPC). This is a cross-sectional study carried out between 2011-2013, following a cluster random sampling strategy. Adult users were interviewed from 15 health services of that 6 were managed by the CHS, 4 by the FHS and 5 by the TPC and which had the same oral health team for at least two years. The final sample was 407 users interviewed using the Primary Care Assessment Tool - Oral Health of Adults evaluation instrument and a sociodemographic questionnaire. PHC scores were calculated and transformed on a scale ranging from 0 to 10. For high scores, the cut-off point > 5.5 was used. Most of the interviewees were females, for the three types of services. The performance of CHS and FHS was higher than those of TPC in almost all attributes (p < 0.05). The extent of PHC attributes in services was poor (overall highest score was 5.75 in CHS). The CHS was the only service witch half of the users (83; 49.1%) rated oral health services as having a high overall score for PHC. It is concluded that there were differences among the organizational arrangements of PHC oral health services, however, there is much to be improved in the orientation of dental care services for PHC. More studies are necessary to evaluate the differences in PHC services considering oral health.

scholarly journals Fragilidades e fortalezas da assistência à saúde do homem na atenção primária à saúde

2020 ◽  
Vol 10 (32) ◽  
pp. 53-61
Author(s):  
Angélica Cristina Silveira Marques ◽  
Adriani Izabel de Souza Moraes ◽  
Sílvia Carla da Silva André Uehara
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Men’S Health ◽  
Men's Health ◽  
Health It ◽  
Access To Health Services ◽  
Primary Health ◽  
Access To Health ◽  
Care Health ◽  
The City

O processo de adoecimento dos homens vem sendo determinado pelo seu comportamento na sociedade e como expressam suas crenças de masculinidade. O objetivo deste trabalho foi identificar as ações realizadas pelos enfermeiros da Atenção Primária à Saúde (APS) direcionadas à promoção da saúde do homem. Trata-se de uma pesquisa descritiva, exploratória e de abordagem quantitativa. A pesquisa foi realizada com 29 enfermeiros de serviços da APS do município de São Carlos-SP. Os dados foram coletados por meio de uma entrevista, utilizando um instrumento validado. Os dados foram analisados por meio da estatística descritiva. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Os resultados mostram que 65,5% (19) dos enfermeiros referiram não ter recebido capacitação sobre a saúde do homem. Quanto aos fatores facilitadores do acesso dos homens nos serviços de saúde, destacam-se que 19% (11) das respostas incluíram o vínculo estabelecido entre os profissionais e usuários; e, como agentes dificultadores, em 35,1% (19) das respostas foi ressaltada a cultura do homem. Para uma maior efetividade da assistência à saúde do homem, torna-se necessário a sensibilização de profissionais e gestores de saúde na busca de estratégias para facilitar o acesso da população masculina aos serviços de saúde.Descritores: Saúde do Homem, Atenção Primária à Saúde, Enfermagem. Fragilities and strengths of man's health care in primary health careAbstract: The illness process of men has been determined by their behavior in society and how they express their beliefs about masculinity. The objective of this study was to identify the actions performed by nurses of Primary Health Care (PHC) directed to the promotion of men's health. It is descriptive, exploratory, and quantitative approach research. The research was conducted with 29 nurses from the PHC services of the city of São Carlos-SP. Data were collected through an interview using an instrument validated. Data were analyzed using descriptive statistics. Still, data collection began after approval by the Research Ethics Committee. The results show that 65.5% (19) of the nurses reported not having received training on men's health. Regarding factors that facilitate men's access to health services, it is noteworthy that 19% (11) of the answers included the bond established between professionals and users; and, as hindering agents, 35.1% (19) of the answers highlighted men's culture. Thus, for greater effectiveness of men's health care, health professionals and managers need to be sensitized in the search for strategies to facilitate the male population's access to health services.Descriptors: Men's Health, Primary Health Care, Nursing. Fragilidades y fortalezas de la atención médica del hombre en la atención primaria de saludResumen: El proceso de enfermedad de los hombres ha sido determinado por su comportamiento en la sociedad y cómo expresan sus creencias sobre la masculinidad. El objetivo de este estudio fue identificar las acciones realizadas por las enfermeras de Atención Primaria de Salud (APS) dirigidas a la promoción de la salud de los hombres. Es una investigación de enfoque descriptivo, exploratorio y cuantitativo. La investigación se realizó con 29 enfermeras de los servicios de APS de la ciudad de São Carlos-SP. Los datos fueron recolectados a través de una entrevista utilizando un instrumento validado. Los datos se analizaron mediante estadística descriptiva. Aún así, la recopilación de datos comenzó después de la aprobación del Comité de Ética en Investigación. Los resultados muestran que el 65.5% (19) de las enfermeras informaron no haber recibido capacitación sobre la salud de los hombres. En cuanto a los factores que facilitan el acceso de los hombres a los servicios de salud, cabe destacar que el 19% (11) de las respuestas incluyeron el vínculo establecido entre profesionales y usuarios; y, como agentes obstaculizadores, el 35,1% (19) de las respuestas destacaron la cultura de los hombres. Por lo tanto, para una mayor efectividad de la atención médica de los hombres, los profesionales de la salud y los gerentes deben ser sensibilizados en la búsqueda de estrategias para facilitar El acceso de la población masculina a los servicios de salud.Descriptores: Salud del Hombre, Atención Primaria de Salud, Nursing.

scholarly journals Measuring the quality of primary care in national health surveys: Lessons from Brazil

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Erno Harzheim ◽  
Luiz F. Pinto ◽  
Otávio P. D'Avila ◽  
Lisiane Hauser
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
National Health ◽  
Assessment Tool ◽  
Household Survey ◽  
Ministry Of Health ◽  
Primary Health ◽  
Care Assessment

Background: South Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until then the only one that had never used it in evaluation of primary health care facilities until 2015.Aim: The authors aim to demonstrate that after the consolidation of Bresick’s team to an African version of PCAT, it had been adapted to household survey in Brazil.Methods: In this letter, authors reflect on how Brazil had adapted PCAT to a national random household survey with Brazilian National Institute of Geography and Statistics (IBGE) – the Brazilian Census Bureau.Results: In the the beginning of 2019, Brazilian Ministry of Health brought back the PCAT as the official national primary health care assessment tool. Brazilian National Institute of Geography and Statistics (IBGE) included a new module (set of questions) in its National Health Survey (PNS-2019) and collected more than 100 000 households interviews in about 40% of the country’s municipalities. This module had 25 questions of the Brazilian validated version of the adult reduced PCAT.Conclusion: We believe that IBGE innovation with the Ministry of Health can encourage South Africa to establish a similar partnership with its National Institute of Statistics (Statistics South Africa) for the country to establish a baseline for future planning of primary health care, for decision-making based on scientific evidence.

scholarly journals Evaluation of Primary Health Care attributes of Fortaleza city, Ceará State, Brazil

2019 ◽  
Vol 72 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Leonardo Barbosa Rolim ◽  
Janássia Gondim Monteiro ◽  
Anya Pimentel Gomes Fernandes Vieira Meyer ◽  
Sharmênia de Araújo Soares Nuto ◽  
Márcio Flávio Moura de Araújo ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Family Health ◽  
A Value ◽  
Primary Health ◽  
Health Strategy ◽  
Care Assessment ◽  
Family Health Strategy

ABSTRACT Objective: To evaluate the Primary Health Care attributes of Fortaleza city, Ceará State. Method: Evaluative study carried out at 97 Primary Health Care Units, from August 2015 to June 2016. 451 professionals from the Family Health Strategy participated in the study. We used the Primary Care Assessment Tool - Brazil, which evaluates the attributes, assigning scores on a scale of zero to ten. We adopted as a cut-off point, to consider high Primary Care score, attributes with a value of 6.60 or higher. Results: Among the eight attributes evaluated the First Contact Access and the Coordination - Information System were the ones that obtained the lowest and highest scores, (2.98) and (7.82), respectively. The Overall Score, calculated by means of a mean of the attributes, was 6.34. Conclusion: The Primary Care evaluated had a low score, showing the need to discuss mechanisms to boost the attributes that obtained low scores.

scholarly journals Relações entre a atenção primária e as internações por condições sensíveis em um hospital universitário

2018 ◽  
Vol 39 (0) ◽  
Author(s):  
Lucia Aparecida de Souza ◽  
Ricardo de Mattos Russo Rafael ◽  
Anna Tereza Miranda Soares de Moura ◽  
Mercedes Neto
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Primary Health ◽  
Care Assessment

Resumo OBJETIVO Analisar as relações entre a presença e a orientação da Atenção Primária à Saúde e as internações por condições sensíveis à atenção primária em um hospital universitário. MÉTODO Estudo seccional com amostra de 197 sujeitos internados no período de março a junho de 2016 na clínica médica de um hospital universitário de Juiz de Fora. A aferição, realizada por meio de entrevistas, utilizou o Primary Health Care Assessment Tool, versão reduzida para adultos, e a lista brasileira de condições sensíveis, editada pelo Ministério da Saúde. RESULTADOS A frequência regular à Atenção Primária esteve associada às internações (RP:2,06), especialmente frente ao baixo desempenho dos atributos de acesso (RP:5,3) e da integralidade (RP:4,7). CONCLUSÃO A baixa orientação dos atributos da Atenção Primária sugere que somente a cobertura deste nível talvez não seja suficiente para reduzir estas internações, mas a forma que ela se organiza e efetiva no nível comunitário.

scholarly journals Evaluation of primary health care for children under 5 years old in the municipality of lagarto-se

2020 ◽  
pp. 758-766
Author(s):  
Adênia Káren Cardoso Costa ◽  
Anne Katherine Nascimento Mesquita ◽  
Anny Giselly Milhome Milhome da Costa Farre ◽  
Karenine Maria Holanda Cavalcante ◽  
Maria do Socorro Claudino Barreiro
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Primary Health ◽  
Care Assessment ◽  
Primary Care Assessment Tool ◽  
Children Under 5

Objetivo: avaliar a efetividade da assistência primária as crianças menores de cinco anos de idade cadastradas em uma Clínica de Saúde da Família, Lagarto-SE. Método: trata-se de uma pesquisa de resultados, de abordagem quantitativa e delineamento transversal, no qual se utilizou Primary Care Assessment Tool – Versão Criança para avaliação dos atributos de acesso, longitudinalidade, coordenação, integralidade, orientação familiar e orientação comunitária. Resultados: foram entrevistados 50 adultos, responsáveis por crianças de até cinco anos de idade cadastradas no serviço. A avaliação foi positiva para o grau de afiliação e o atributo coordenação-sistema de informações, e os demais não alcançaram o escore mínimo de referência. Conclusão: os atributos revelam há barreiras no acesso ao serviço, falha na continuidade do atendimento, fragilidade na referência e contra-referência e comprometimento na comunicação profissionais de saúde-paciente.

scholarly journals Building health system resilience in the context of primary health care revitalization for attainment of UHC: proceedings from the Fifth Health Sector Directors’ Policy and Planning Meeting for the WHO African Region

2020 ◽  
Vol 14 (S19) ◽  
Author(s):  
Prosper Tumusiime ◽  
Humphrey Karamagi ◽  
Regina Titi-Ofei ◽  
Michelle Amri ◽  
Aminata Binetou Wahebine Seydi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Health Systems ◽  
Health Sector ◽  
Health Systems Strengthening ◽  
Health Coverage ◽  
African Region ◽  
Health Service Provision ◽  
Primary Health

Abstract Background The recent 2018 Declaration of Astana recognized primary health care (PHC) as a means to achieve universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs). Following this declaration, country progress on operationalization of the PHC agenda and attainment of UHC has been stalled by the new challenges posed by the COVID-19 pandemic. The pandemic has also disrupted the continuity of essential health service provision and tested the resilience of the region’s health systems. Methods In accordance with this, the WHO Regional Office for Africa convened the Fifth Health Sector Directors’ Planning and Policy Meeting across the 47 Member States of the Region. The two-day forum focused on building health system resilience to facilitate service continuity during health threats, PHC revitalization, and health systems strengthening towards UHC. Results The Regional Forum provided evidence on building resilient health systems in the WHO African Region and engaged participants in meaningful and critical discussion. It is from these discussions that four key themes emerged: (1) working multisectorally/intersectorally, (2) moving from fragmentation to integration, (3) ensuring implementation and knowledge exchange, and (4) rethinking resilience and embracing antifragility. These discussions and associated groupings by thematic areas lend themselves to recommendations for the WHO. Conclusions This paper details the proceedings and key findings on building resilient health systems, the four themes that emerged from participant deliberation, and the recommendations that have emerged from the meeting. Deliberations from the Regional Forum are critical, as they have the potential to directly inform policy and program design, given that the meeting convenes health sector technocrats, who are at the helm of policy design, action, and implementation.

scholarly journals Validity and reliability of the Brazilian Primary Care Assessment Tool: Oral Health of Adults

2020 ◽  
Vol 23 ◽  
Author(s):  
Débora Deus Cardozo ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Liége Teixeira Fontanive ◽  
Erno Harzheim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Assessment Tool ◽  
Validity And Reliability ◽  
Dental Services ◽  
Primary Health ◽  
Care Assessment ◽  
Primary Care Assessment Tool

ABSTRACT: Objective: To test the factorial validity and reliability of the Primary Care Assessment Tool adapted to Oral Health, adult patient version, an instrument used to verify the presence and extent of attributes in Primary Health Care services. Methods: Population-based cross-sectional study using conglomerate random sample carried out in Primary Health Care Dental services in Porto Alegre between 2011 and 2013. We interviewed 407 adult patients who used Primary Health Care Dental services. Construct validity was tested through factorial validity and reliability of the Primary Care Assessment Tool, that comprises 81 items distributed throughout Primary Health Care attributes. Equamax orthogonal rotation method was used in the factorial analysis; and, in order to assess reliability of each component, we used the item-total correlation and the ratio of success of the scale. Results: In the factorial analysis, 10 factors were retained, explaining 53.3% of the total variation. This result demonstrates the multidimensional structure of the instrument. The reliability assessment showed Cronbach’s alpha values ranging from 0.39 to 0.89. For the success of the scale most of the results (eight of nine attributes) were greater than 85%. Conclusions: The instrument is valid for the assessment of oral health services in Primary Health Care from the perspective of adult patients, as well as for monitoring and evaluation of oral health services in Primary Health Care attributes and comparative studies.

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