Remoto ou remotos: a saúde e o uso do território nos municípios rurais brasileiros

Bousquat, Aylene; Fausto, Márcia Cristina Rodrigues; Almeida, Patty Fidélis de; Lima, Juliana Gagno; Seidl, Helena; Sousa, Amandia Braga Lima; Giovanella, Lígia

doi:10.11606/s1518-8787.2022056003914

Cited by 10 publications

(11 citation statements)

References 17 publications

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“…A qualitative study was conducted based on interviews with PHC doctors in the research "Primary Health Care in Remote Rural Territories in Brazil". Of the 323 RRMs defined by the Geography and Statistics Brazilian Institute 7 , six areas with distinct socio-spatial logics were considered for research purposes: the North region, subdivided into "North-waterways" and "North-roads", "Matopiba" (an agricultural frontier expansion region connecting Maranhão, Tocantins, Piauí and Bahia), Midwest Vector, Semiarid region, and the North of Minas Gerais 4 .…”

Section: Methodsmentioning

confidence: 99%

“…Municipalities from each area, with both typical and atypical characteristics, were selected in nineteen socioeconomic and health indicators, as described by Bousquat et al 4 . The intentional sample of municipalities for the research field, structured from these six areas, was used in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Territorialization is a guideline provided for in the National Primary Care Policy (PNAB, in Portuguese), which defines the structuring models of its services, considering specific principles, such as longitudinality, resolution, and network ordering, among others 5 . However, the PNAB lacks the affirmation of flexible, integrated models in healthcare networks, in which territorialization fits the movements, as is necessary in the RRMs 4,16 . It is not a matter of preventing the patient flows between the countryside and the municipal headquarters, and accepting walkin appointments, but of reconciling the work in the office and in the territory so that health care needs can be seen beyond the demands of caring in the context of the community and of the extension of time, and not merely of the individual and the moment.…”

Section: Weak Reference Link To the Phc Unit Territory I Wouldn't Be ...mentioning

confidence: 99%

“…A clear, customized policy is needed to reverse this situation and ensure the public provision of healthcare services, especially those of Primary Health Care (PHC), which must be constant and integrated into the healthcare networks. In fact, PHC is the main -and sometimes only -form of access to health care in these territories 1,4 . The National Health Policy for Rural, Forest, and Water Populations (Política Nacional de Saúde das Populações do Campo, Floresta e Águas, in Portuguese) sought to give visibility and a better response to the inequities of these peoples in Brazil 3 .…”

Section: Introductionmentioning

confidence: 99%

“…In the Brazilian Unified Health System (SUS, in Portuguese), the Family Health Strategy (FHS) is the preferred PHC model and is present in practically all Brazilian municipalities 4 . The FHS is guided by the relationship of a multidisciplinary team with the users enrolled in a defined territory, in which health care extends from individuals to the perspective of the territory itself 5 .…”

Section: Introductionmentioning

confidence: 99%

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Doctors’ Work in Primary Health Care in remote rural municipalities: where is the territory?

Franco

Giovanella

Bousquat

2023

Ciênc. saúde coletiva

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Resolute and comprehensive health care in remote rural municipalities (RRMs) requires Primary Health Care (PHC) with a strong community dimension anchored in the territory. This paper aims to analyze the performance profile of doctors in PHC, considering their work both in the territory and in PHC units. The perspective of doctors, critical agents in PHC, contributes to understanding whether there is an equitable and comprehensive availability of PHC. A qualitative study was carried out in 27 RRMs, with interviews with 46 Family Health doctors. Content analysis, structuring results in dimensions of arrangements in the performance of doctors in the territories and the organization of activities at the PHC units. Doctors concentrated their activities in the PHC units, primarily in municipal headquarters, with heterogeneous work agreements. Knowledge about the characteristics of the territory and the population was weak, especially those assigned at a considerable distance from municipal headquarters. In the rare work conducted within the territory, an itinerant and/or campaigning model was observed, with the mark of discontinuity. Walk-in patients were prioritized over care actions of follow-up and planning. The findings indicate the need to reinforce interaction with the territory in the provision of PHC services in RRMs.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Weak Reference Link To the Phc Unit Territory I Wouldn't Be ...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Doctors’ Work in Primary Health Care in remote rural municipalities: where is the territory?

Franco

Giovanella

Bousquat

2023

Ciênc. saúde coletiva

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Challenges to the provision of specialized care in remote rural municipalities in Brazil

Nunes

Santos

Carneiro

et al. 2022

BMC Health Serv Res

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This case study analyses the challenges to providing specialized care in Brazilian remote rural municipalities (RRM). Interviews were conducted with managers from two Brazilian states (Piauí and Bahia). We identified that the distance between municipalities is a limiting factor for access and that significant care gaps contribute to different organizational arrangements for providing and accessing specialized care. Physicians in all the RRMs offer specialized care by direct disbursement to users or sale of procedures to managers periodically, compromising municipal and household budgets. Health regions do not meet the demand for specialized care and exacerbate the need for extensive travel. RRM managers face additional challenges for the provision of specialized care regarding the financing, implementation of cooperative arrangements, and the provision of care articulated in networks to achieve comprehensive care, seeking solutions to the locoregional specificities.

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Características contextuais e procura por serviços de saúde entre adolescentes brasileiros: Pesquisa Nacional de Saúde, 2019

Silva,

Nunes,

Lima

et al. 2023

Cad. Saúde Pública

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Resumo: Os objetivos foram descrever a prevalência de procura por serviços de saúde entre adolescentes brasileiros e investigar sua associação com características contextuais do território. O estudo utilizou dados da Pesquisa Nacional de Saúde de 2019, realizada com 43.774 indivíduos de 10 a 19 anos. A informação do adolescente foi obtida por meio de um morador proxy de 18 anos ou mais que respondia por si e por todos os moradores da casa. A regressão de Poisson foi utilizada para avaliar a procura por serviços de saúde de acordo com região geopolítica, situação censitária e tipo de município. Também foi avaliada a interação da variável “plano de saúde” nessas associações. Do total, 11,7% (IC95%: 11,1; 12,3) dos adolescentes procuraram serviços de saúde nas duas semanas anteriores à pesquisa. Maiores prevalências de procura foram observadas nas regiões Sudeste (RP = 1,32; IC95%: 1,15; 1,52) e Sul (RP = 1,31; IC95%: 1,13; 1,52) em comparação à Região Norte do país. O acesso a plano de saúde aumentou a busca pelos serviços por adolescentes residentes nas áreas rurais e nas capitais e municípios das Regiões Metropolitanas e/ou Regiões Integradas de Desenvolvimento. O estudo evidenciou baixa prevalência de procura por serviços de saúde entre adolescentes e desigualdades contextuais para a região geopolítica. Ter plano de saúde foi um marcador importante para entender as disparidades na situação censitária e no tipo de município.

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Remoto ou remotos: a saúde e o uso do território nos municípios rurais brasileiros

Cited by 10 publications

References 17 publications

Doctors’ Work in Primary Health Care in remote rural municipalities: where is the territory?

Doctors’ Work in Primary Health Care in remote rural municipalities: where is the territory?

Challenges to the provision of specialized care in remote rural municipalities in Brazil

Características contextuais e procura por serviços de saúde entre adolescentes brasileiros: Pesquisa Nacional de Saúde, 2019

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