Health in cities: is a systems approach needed?

Roux, Ana V. Diez

doi:10.1590/0102-311xde01s115

Cited by 37 publications

(22 citation statements)

References 10 publications

(8 reference statements)

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“…Moreover, these results suggest the need for investment in the FHS teams' working processes to keep competences related to dimensions focused on respect for people, and of enhancing the health care network to improve local health system conditions, which affect the dimensions oriented to clients, mainly agility in services and possibility of selecting the professional. (16)(17)(18) Thus the PHC in the Federal District should progress in the light of the PHC's social building. Because the structure of supply is very limited, as suggested by the results of this study, it probably responds only partially to the demands resulting from acute conditions and worsened chronic conditions and to the demands for preventive care, administrative demands and, sometimes, demand for home care.…”

Section: Discussionmentioning

confidence: 99%

“…The systemic approaches of urban management that foster the capacity of generating co-benefits are useful mainly to improve the population's health. (16,17) A limitation of the study is the potential bias of prevalence typical to cross-sectoral studies. Another potential limitation is the gratitude bias that could have been omitted in this evaluation, mainly because it approaches public services.…”

Section: Discussionmentioning

confidence: 99%

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Índice de Responsividade da Estratégia Saúde da Família da Zona Urbana

et al. 2016

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Objective: To evaluate the Family Health Strategy Index of Responsiveness in urban areas of the Federal District. Methods: This is an exploratory descriptive study. A questionnaire was applied from May 1 to July 31, 2014 approaching 242 users with the following dimensions of responsiveness: a) respect the people: dignity, confidentiality, autonomy, communication; b) orientation to client: facilities, selection of professional, agility in services and social support that were used to calculate the Index of Responsiveness. The best indexes of responsiveness were found in dimensions focused on respect for people, including being treated with dignity, assurance of confidentiality and good communication with professionals. User's autonomy appeared as an attribute to be improved by professionals. The dimensions related to orientation to client performed worst, except for social support. Facilities were considered to be regular, while agility and possibility of selection of professional were unsatisfactory. Conclusion: The Family Health Strategy (FHS) units should improve the aspect of orientation to client, mainly regarding infrastructure and coordination with the health care network. ResumoObjetivo: Avaliar o Índice de Responsividade da Estratégia Saúde da Família das áreas urbanas do Distrito Federal. Métodos: Estudo descritivo exploratório. Aplicou-se um questionário entre os dias 1 de maio a 31 de julho de 2014 com 242 usuários, que continha as dimensões de responsividade: a) respeito pelas pessoas: dignidade, confidencialidade, autonomia, comunicação; b) orientação para o cliente: instalações, escolha profissional, agilidade no atendimento e apoio social, que foram utilizadas para o cálculo do Índice de Responsividade. Resultados: Foram avaliados positivamente a dignidade, com o índice de 0,902 (excelente), a confidencialidade, com 0,838 (muito bom), a comunicação, com 0,833 (muito bom), o apoio social, com 0,814 (muito bom) e a autonomia, com o índice de 0,746 (bom). As instalações e agilidade foram avaliadas como regular, com os índices 0,649 e 0,613, respectivamente. A dimensão de escolha do profissional foi avaliada como péssimo com o índice de 0,169. Discussão: Verificou-se que tiveram os melhores índices de responsividade as dimensões voltadas para o respeito pelas pessoas, que inclui o ser tratado com dignidade, ter a garantia da confidencialidade, e ter boa comunicação com os profissionais. A autonomia do usuário revelou-se como um atributo que deve ser melhorado pelos profissionais. As dimensões atinentes à orientação para o cliente obtiveram os piores índices, exceto o apoio social. Foram consideradas regulares as instalações e insatisfatórias a agilidade e a possibilidade de escolha profissional. Conclusão: As unidades da ESF devem melhorar no aspecto orientação para o cliente, sobretudo no que se refere à infraestrutura e articulação com a rede de atenção.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Índice de Responsividade da Estratégia Saúde da Família da Zona Urbana

et al. 2016

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“…But on the technical side, one problem is that the direct relationship between decentralization/regionalization and equity is not something simple to demonstrate -beginning with the difficulty in defining dependent and independent variables 14 . Furthermore, there is the complexity of how to read the data and factors related to the municipality 15 . As a contribution to analyses of the process of healthcare regionalization, this article presents a systematic review of the recent experiences of regional organization of Brazil's SUS, in search of the main factors conditioning this process in Brazil.…”

Section: Introductionmentioning

confidence: 99%

O processo de regionalização do SUS: revisão sistemática

Mello

Pereira

Uchimura

et al. 2017

Ciênc. saúde coletiva

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“…Based on the premise that health events are associated with attributes of individuals nested in the "urban place" and in these individuals' aggregate properties, Urban Health incorporates the properties of the place and the role of the physical and social environments as health determinants of persons in places, demanding unique approaches 5,6,7,8 .…”

Section: Introductionmentioning

confidence: 99%

Urban upgrading and its impact on health: a “quasi-experimental” mixed-methods study protocol for the BH-Viva Project

et al. 2015

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There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a “quasi-experimental”, multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents’ health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the “formal city”, increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.

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Health in cities: is a systems approach needed?

Cited by 37 publications

References 10 publications

Índice de Responsividade da Estratégia Saúde da Família da Zona Urbana

Índice de Responsividade da Estratégia Saúde da Família da Zona Urbana

O processo de regionalização do SUS: revisão sistemática

Urban upgrading and its impact on health: a “quasi-experimental” mixed-methods study protocol for the BH-Viva Project

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