Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
D Soranz ◽  
L J Santos ◽  
M S Paranhos ◽  
L S Malta ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Health Survey ◽  
Household Surveys ◽  
Mato Grosso ◽  
Primary Health ◽  
The World ◽  
Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

scholarly journals Primary health care and national household random sampling surveys: contributions from Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
M R Gonçalves ◽  
N Katz ◽  
R S Silva ◽  
C A A Schmitz ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Systems ◽  
National Health ◽  
Health Survey ◽  
Health Surveys ◽  
Primary Health ◽  
The World ◽  
National Health Surveys

Abstract Primary health care has been considered by the World Health Organization (WHO) as the most efficient way of organizing health systems in order to achieve universal health coverage, preserving its attributes and focusing on people. Several countries in the world have developed instruments to measure access, use of services and lifestyles of their populations. In Europe, European Union members have validated the European Health Interview Survey (EHIS / Eurostat), which is in its third wave of application. Brazil, for over 20 years, has developed, through the Brazilian Institute of Geography and Statistics (IBGE) - the Brazilian Federal Statistics Bureau - in partnership with the Ministry of Health, a national household health survey throughout its territory, the so-called National Health Survey (PNS). PNS-2019 questionnaire innovated by including a module of questions that allows assessing the scores of the attributes proposed by Shi and Starfield in the 2000s. The Primary Care Assessment Tool (PCAT) was included in its brazilian statistically validated version for adult users and applied in more than 100,000 households in all five regions and 27 states in Brazil. Over a six-month period, a sample of approximately 10,000 adults was registered, according to the inclusion criteria of the PCAT considered (being 18 years old or older, having had more than one medical appointment in the last six months, having performed this appointment in a public primary health care facility). We consider it essential to use statistically validated instruments that allow cross-country comparisons and we encourage Governments all over the world to follow Brazilian example in incorporating in their national health surveys a module containing the validated version of the PCAT. This instrument has already been validated and used in the evaluation of primary care in regions of all five continents of the world, demonstrating, therefore, its capacity for cultural adaptation to each reality. Key messages PCAT's set of instruments remains current for the evaluation of primary health care services from the users' perspective nationwide. The importance of using National Health Surveys in each country, with random household sampling to assess health systems and conditions.

scholarly journals Validation of the comprehensiveness of an instrument on ethical problems in primary care

2014 ◽  
Vol 35 (1) ◽  
pp. 148-156 ◽  
Author(s):  
José Roque JUNGES ◽  
Elma Lourdes Campos Pavone Zóboli ◽  
Rafaela SCHAEFER ◽  
Carlise Rigon Dalla NORA ◽  
Mikaela BASSO
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Ethical Problem ◽  
Ethical Problems ◽  
Methodological Research ◽  
Primary Health ◽  
Initial Stage

The study aimed to validate the comprehensiveness of an instrument on the occurrence of ethical problems in primary health care and discuss their results. This is a methodological research. The technique used was Delphi, which seeks to obtain a consensus on a subject by experts, using structured questionnaires that are modified to obtain consensus on the comprehensibility of content. The sample was composed by nine professionals with expertise in primary health care in São Leopoldo. Data collection was in March and April 2011. In the first round, the professional was asked to respond whether the described situation has represented an ethical problem, whether the statement was clear and whether there was any suggestion to rewriting the problem. Were presented thirty-six statements, and to twenty was suggested new rewrite. After the review and systematization the proposed amendments, has begun the second round to seek consensus among all the statements that its writing had changed. In the second round, the consensus required by the method was obtained. Using the method supported significantly to build the instrument in its initial stage, what makes it appropriated and comprehensive for the subsequent steps of the validation.

An Overview of Primary Health Care

1976 ◽  
Vol 6 (2) ◽  
pp. 309-314 ◽  
Author(s):  
John Fry
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
World Health Organization ◽  
Critical Analysis ◽  
World Health ◽  
Training And Education ◽  
Primary Health ◽  
The World ◽  
Health Organization

Primary health care has become a focus of interest from the World Health Organization down. The hopes that more emphasis on primary care will lead to less expensive and better care will not be realized unless a more critical analysis of its problems is undertaken and some of its defects and deficiencies put right. Its roles must be better defined and the work shared within a team; training and education must be more related to its needs; and much sharper research is required to decide what is useful and what is useless.

Provision of rehabilitation of the disabled on the community level

1980 ◽  
Vol 209 (1174) ◽  
pp. 139-140 ◽  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
World Health ◽  
Household Surveys ◽  
World Health Assembly ◽  
Primary Health ◽  
Health Authorities ◽  
The World ◽  
The Disabled ◽  
First Time

A few years ago, when the World Health Assembly adopted the resolution on primary health care, it was decided to include rehabilitation of the disabled as an integral part of the programme. Thus the needs of the 400 million disabled in the world were for the first time recognized as a priority by the most representative body in the world of health authorities and experts. What is the W. H. O. doing to implement this resolution? First, a couple of household surveys in developing countries were undertaken, and we were able to confirm that the estimate of 10% disabled was correct. We were also able to go a step further: it would be reasonable to estimate that at any one day 60 million people in the world could be helped to a better life through the provision of rehabilitation - through the improvement of their functional capacity, through education and vocational measures and, not the least, through a better understanding of their problems and better acceptance in the community - all of this aiming at better integration of the disabled into the mainstream of our societies.

scholarly journals The role of primary care pharmacists in the response to the Zika epidemic

2021 ◽  
Vol 19 (2) ◽  
pp. 2290
Author(s):  
Cláudia B. Santos-Pinto ◽  
Claudia S. Osorio-de-Castro ◽  
Larissa M. Ferreira ◽  
Elaine S. Miranda
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Knowledge ◽  
Preventive Measures ◽  
Knowledge Gaps ◽  
Mato Grosso ◽  
Primary Health

Background: Zika virus (ZIKV) infection emerged in Brazil in 2015, leading to the declaration of a national public health emergency, mainly due to its consequences for pregnant women and newborn babies. The Zika epidemic demanded major efforts from the public health system to address the full range of disease consequences. Objective: The objective of this study was to investigate the role of Primary Health Care pharmacists working in the city of Campo Grande in the State of Mato Grosso do Sul. Methods: A qualitative cross-sectional interview-based study with pharmacists working in municipal Primary Health Care services was carried out to investigate knowledge about the disease and involvement in the response to the health emergency. Informed consent was obtained. After coding, the corpus underwent thematic analysis. Results: The data show that few professionals had received specific training in public health. Knowledge largely encompassed disease transmission by the mosquito and collective and individual preventive measures. Findings highlight knowledge gaps relating to signs and symptoms, diagnosis, consequences of infection, and the role of epidemiological surveillance. Most professionals mentioned at least one of the recommendations on the use of medicines in symptom management protocols. The practical implications surrounding knowledge gaps and misconceptions were reflected in pharmacists´ role in response, restricted to counselling on preventive measures. Few respondents participated in institutional groups and committees or in multiprofessional teams involving case management. Conclusions: The study identified important knowledge gaps and showed that the involvement of pharmacy professionals in the response to the Zika epidemic was timid or inadequate. The results also suggest that pharmacists failed to recognize their role in interventions related to the ZIKV epidemic. Findings highlight the need to increase the involvement of primary care pharmacists in community-based actions, for communication and reduction of health risks, and emergency preparedness and response.

Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care

2004 ◽  
Vol 19 (5) ◽  
pp. 250-257 ◽  
Author(s):  
Katrin Barkow ◽  
Reinhard Heun ◽  
T. Bedirhan Üstün ◽  
Mathias Berger ◽  
Isaac Bermejo ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
General Health ◽  
Depressive Disorders ◽  
Somatic Symptoms ◽  
Anxiety Symptoms ◽  
Primary Health ◽  
The World ◽  
Detection Of Depression

AbstractSomatic symptoms and anxiety symptoms are often disregarded in the detection of depression in primary care. The present investigation examined to what extent somatic and anxiety symptoms recorded with the Composite International Diagnostic Interview—Primary Health Care Version (CIDI—PHC) can improve the detection of depression as compared to the General Health Questionnaire—12-item version alone. Data from the World Health Organization study on Psychological Problems in General Health Care were used. The study sample consisted of primary care attenders from 15 centres from all over the world who underwent a psychiatric examination with the CIDI—PHC. Medically unexplained somatic symptoms (back pain, feelings of heaviness/lightness in parts of the body, periods of bodily weakness, seizures/convulsions, permanent tiredness, exhaustion after a minimum of effort) and—to a smaller extent—diverse anxiety symptoms (e.g. feelings of anxiousness/nervousness, feelings of tension, difficulties relaxing) significantly contributed to the detection of depression in a logistic regression analysis. The results confirm the observation that in primary care somatic symptoms play an important role in the manifestation of depressive disorders. The items investigated herein could prove beneficial for future depression screening instruments to improve the detection of depressive disorders in primary care.

Primary Health Care and Person Centered Medicine

2015 ◽  
Vol 5 (2) ◽  
pp. 45-50
Author(s):  
Juan E Mezzich ◽  
James Appleyard ◽  
Michel Botbol ◽  
Tesfa Ghebrehiwet ◽  
Joanna Groves ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
World Health ◽  
Special Role ◽  
The Past ◽  
Primary Health ◽  
The World ◽  
Global Initiative ◽  
Health Organization

The popular usual meaning of primary care is health care at a basic rather than specialized level for people making an initial approach to a doctor or nurse for treatment. The concept of primary health care has evolved dramatically over the past four decades, particularly under the aegis of the World Health Organization with the additional participation of other institutional actors around the world. It is increasingly recognized as a fundamental concept and strategy for the advancement of health care and the promotion of health at national and international levels.Separately, as the programmatic global initiative on person centered medicine has been unfolding over the past decade, primary care, not surprisingly, is emerging as a prominent topic and concern for advancing person-centered medicine and health care. There are certainly conceptual and strategic reasons for such emergence. There have been as well institutional reasons for this. At the same time, person-centeredness is an open road for the optimization of primary care.Further understanding of the prominent position, special role, and particular challenges of primary care in person centered medicine is contributed by several of the papers published in the present issue of the International Journal of Person Centered Medicine.

scholarly journals Evaluation of Inappropriate Prescribing in Patients Older than 65 Years in Primary Health Care

2019 ◽  
Vol 8 (3) ◽  
pp. 305 ◽  
Author(s):  
Antonio Nuñez-Montenegro ◽  
Alonso Montiel-Luque ◽  
Esther Martin-Aurioles ◽  
Felicisima Garcia-Dillana ◽  
Monica Krag-Jiménez ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Inappropriate Prescribing ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Primary Health ◽  
Start Criteria ◽  
Inappropriate Prescriptions

To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care. Design: cross-sectional study. Setting: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain. Participants: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area. The data were collected by interview on a structured data collection form. Study variables. Dependent variable: Potentially inappropriate prescribing (PIP) (STOPP/START criteria). Predictor variables: Sociodemographic characteristics, clinical characteristics and medication use. A descriptive analysis of the variables was performed. Statistical inference was based on bivariate analysis (Student’s t or Mann-Whitney U test and chi-squared test) and multivariate analysis was used to control for confounding factors. 73.6% of participants met one or more STOPP/START criteria. According to information about prescribed treatments, 48.5% of participants met at least one STOPP criterion and 43.30% of them met at least one START criterion. The largest percentage of inappropriate prescriptions was associated with cardiovascular treatments. More than three-quarters of the participants had one or more inappropriate prescriptions for medicines in primary care, according to STOPP/START criteria. In addition, PIP was directly related to the number of prescribed medications, gender and specific pathologies (diabetes).

scholarly journals Actual problems of outpatient pediatrics and their solutions (reflections and offers of the veteran)

2019 ◽  
Vol 19 (4) ◽  
pp. 249-254
Author(s):  
Antonina G. Gracheva
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Practical Experience ◽  
Primary Health ◽  
The World ◽  
Shortage Of Physicians ◽  
Primary Care Institutions ◽  
The City

There is presented the analysis of the state of ambulatory pediatrics and there are formulated proposals for the priority support for the development of outpatient pediatrics in the framework of improving primary health care for children for the prevention of the shortage ofpediatricians and providing the reduction in morbidity, disability and community-acquired mortality rate. To reduce the long-term shortage of physicians in ambulatory pediatrics author proposes to introduce a new specialty "general pediatrician", which is aimed to prepare a pediatrician at the postgraduate stage for the implementation ofprimary care across all the medicine of children age. The effectiveness of this solution has been proved by the World practice and domestic experiment in the city of Orenburg. It is moreover proposed to use a target distribution of graduates ofpediatric faculty, studied on a budgetary basis, to the outpatient primary care institutions. The organization of postgraduate specialization in ambulatory pediatrics according to the author opinion, should be implemented on the base of Departments of outpatient pediatrics possessing scientific and practical experience in the training of doctors specializing in ambulatory pediatrics.

scholarly journals Adaptation and reorganisation of primary care facility during COVID-19 pandemic: a perspective from primary health care corporation, Qatar

2020 ◽  
Vol 8 (1) ◽  
pp. 434
Author(s):  
Abdul Bari Shaik ◽  
Noor Fathima Shaik ◽  
Shawqiya Salman Al Majid ◽  
Sanaulla Sheik
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Healthcare Providers ◽  
Care Facility ◽  
Well Being ◽  
Safe Delivery ◽  
Primary Health ◽  
The World

The COVID-19 pandemic has brought unprecedented challenges to healthcare systems across the world. It has had a devastating impact on peoples’ health, well-being and livelihood, crippling the economy, aviation, travel, hospitality and various other sectors. In order to curb its impact various governments had to take drastic measures to deal with this crisis. In Qatar, the major healthcare providers led by the MOPH responded swiftly by implementing major changes. They developed infrastructure, revisited public health policies, modified their operations and functioning which helped to cope with this evolving public health emergency. This paper reviews how a small health center in Qatar had to adapt its services, infrastructure and pathways to the changing needs and demands in a timely fashion leading to improved patient care and helping to contain the outbreak in both patients and staff alike. It also evaluates how Primary health care corporation at an organization level paved the transition in every aspect to ensure efficient and safe delivery of primary care services to everyone. As the world is preparing to overcome the pandemic, the paper highlights the value of teamwork in responding to the adversity by creating innovative ways of working and how good leadership can have a positive influence on healthcare and society in general.   

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