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

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.

Assessment of Primary Health Care Attributes in Campina Grande, Paraíba, Brazil

“…A nationally-based study found scores of 8.1 in the Northeast and South, and 7.9 in the Southeast and North (11) . It is possible that the training focused on PHC of Cuban doctors in this study influenced the results verified, since they were higher than those verified in Ceará (6.05) (18) , Goiás (6.8) (17) , São Paulo (7.0) (19) , and Espírito Santo (7.99) (15) .…”

“…The essential score found in the current study was 6.89, and 7.16 for the general score. However, in another study conducted in Ceará, all attributes were negatively assessed, with an essential score of 6.05 and a general score of 6.35 (18) .…”

“…Despite the concentration of studies in the Southeast (15,(19)(20) and South (12,21) regions, negative assessments for First contact access were unanimous. This is the case of studies in Rio Grande do Sul and Ceará, which had a general score of 7.52 (12) and 6.49 (18) , respectively, but both found a negative assessment of accessibility. In contrast, in China (7) and South Africa (8) this attribute was present.…”

“…Moreover, the expansion of FHS coverage over the years, reaching 64.67% in 2019 (27) , has been compromised by the reduction of federal investment in health since 2015 (30) . Although these PCATooL issues have been identified as inadequate to the Brazilian reality (18) , they reflect the extent to which these services still need to advance in order to adapt to an ideal PHC model, starting with increasing service coverage, expanding the functioning of units and non-face-to-face communication (telephone or e-mail) (28) .…”

“…In China, general practitioner assessment obtained better results in relation to other PHC doctors (7) . Brazil has a higher concentration of these studies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) , with a noticeable lack in northeastern Brazil (18) .…”