Infrastructure and work process in primary health care: PMAQ in Ceará

Abstract

OBJECTIVE: To analyze the quality of the infrastructure and work process of the Family Health Strategy in the municipalities of Ceará between 2012 and 2014. METHODS: Cross-sectional study, using secondary data from the external evaluation of the 1st (2012) and 2nd (2014) cycle of the National Program for Improvement of Access and Quality of Primary Care in Ceará. A total of 20 composite indicators were used to verify the quality of infrastructure and work process. RESULTS: Data from 183 (99.4%) of the 184 municipalities of Ceará were collected in both cycles. A total of 1,441 teams were evaluated for the infrastructure and 800 for the work process. Among the 20 composite indicators evaluated, 18 presented an improvement, but in a non-homogeneous way, ranging between 0.0 and 413.5%. We observed that the lower the initial value of the indicator, the greater the variation in quality between 2012 and 2014. The indicators of infrastructure and work process were influenced by the regional health system and population size of the municipality, being more evident the influence on the variables of the work process. CONCLUSIONS: We identified that quality improvements related to infrastructure and work process occurred in the period of implementation of the program in the state of Ceará in an equitable manner, being influenced by population size and regional health system, showing the influence of the context in the implementation of public policies of this nature.

Qualidade da Atenção Primária à Saúde infantil em estados da região Nordeste

“…Estudo realizado no Ceará que analisou dados do PMAQ reforçou que os itens avaliados relativos à vacinação também foram bem avaliados nos dois ciclos anteriores do PMAQ, pois os municípios têm baixa interferência nesta atividade, já que têm maior dependência do MS 26 .…”

What Primary Care mechanisms impact mortality in children under five?

“…Large gaps in human resources contribute to the persistently high levels of maternal and under-ve mortality observed in low-and middle-income countries [56].The infrastructure dimension requires nancial resources for its maintenance, which are only sometimes available, and additional management support for better allocation in the health system, considering users' health needs [57]. Speci c mechanisms include geographical and organizational availability and accessibility to primary care facilities [58,59], inventory of medicines and supplies [25,60], appropriate infrastructure for clinical and administrative activities [25], and the availability of relevant technologies for record-keeping practices [56].…”

Sistematização dos processos de trabalho na gestão pública de práticas integrativas em saúde: relato de caso

“…Na área da saúde é muito frequente a discussão sobre PT das equipes assistenciais (Gleriano et al, 2021;Nunes et al, 2018;Vieira-Meyer et al, 2020;Vizzoni et al, 2021), bem como é tradicional o cálculo para dimensionamento de equipes assistenciais, em especial da enfermagem (Carvalho & Nascimento, 2020;de Oliveira et al, 2022;Moraes et al, 2021;Nishiyama et al, 2020), olhando para o que se entende como gestão em saúde.…”