Reforma da Atenção Primária à Saúde no Rio de Janeiro: comemorando os 450 anos de fundação da cidade

Abstract

Primary Health Care Reform in the city of Rio de Janeiro began in 2009 with the approval of the legal framework for the implementation of a new administrative model governance and management support from their municipal units. It has been developed in some axes involving changes in management model and health care. The coverage of the Family Health Strategy (FHS) by December 2008 was around 3.5%. From this year, a radical change in health management at the local level was initiated. Strong emphasis was given to primary health care, through the encouragement of the Family Health Strategy, coming to the end of the year 2015 at a coverage of about 50% of Rio, exceeding three million people registered and monitored by the Family Health Teams (FHT). . This impressive program was built on firm founding principles, which many countries and states can learn from. It required political will (evident from the time of the relevant constitutional reforms of 1988); a clear commitment to reducing sociodemographic health inequalities, by prioritizing services for the more deprived communities; emphasizing the need to make partners of the individuals, families, and leaders of communities where the clinics are based; taking seriously the principles of preventive care and health literacy, by going beyond vaccination and family planning programs into educational and social interventions; and aiming to reduce hospital use by early diagnosis and referral management. All these mean that Rio has moved much closer to universal health coverage, and -like other parts of Brazil since the FHS reforms -have seen significant falls in morbidity and mortality, especially among the under 5s.The Family Clinics have also taken an important step to raise standards of health care, and to strengthen the skills and attitudes of the medical workforce. They provide centers for training health care staff, and particularly encourage residents and students to become more aware of how primary health care is both an enjoyable and worthwhile setting in which to work. The training of family medicine specialists in Rio is becoming one of the many strengths of the municipality's reforms -encouraging and enabling bright young doctors to take up a post in clinics which are attractive to work in, and well supported and protected by the presence of other staff and the support of the local community. Although not all doctors working in the FHS are as yet fully qualified as family medicine specialists, this new cadre of staff will in turn inspire others to follow their example, and ensure that the people can get good medical services in one setting, without unnecessary expenditure or delay.The challenges to Rio in continuing its success are likely to be the same as those in other states and countries -first, ensuring continuing political commitment to the community and primary health sector, which translates into sustained investment and development. This needs knowledge about effective models for health systems financing; clear and unbiased decision making around pu...

Expansão da atenção primária à saúde no município do Rio de Janeiro em 2010: o desafio do acesso e a completude das equipes de saúde da família

“…Na pesquisa realizada por Malta, 25 os autores apresentaram a cobertura da ESF estimada pela Pesquisa Nacional de Saúde (PNS), comparando com dados administrativos e coberturas anteriores da Pesquisa Nacional por Amostras de Domicílios (PNAD) e evidenciaram que, na Região Sudeste, o Estado do Rio de Janeiro é o que apresenta a menor cobertura, proporcionalmente. Entretanto, quando avaliada a cobertura do Município do Rio de Janeiro, nota-se que entre os anos de 2008 e 2013, houve ampliação de 3,5% para 41%.…”

“…17,18,19 Este trabalho tem como objetivo analisar a expansão da AB, em especial das ESF, no Município do Rio de Janeiro, quanto à sua distribuição por AP e a completude de suas equipes sob a ótica da equidade e da justiça social. 26,7 Coleta de dados sobre as ESF As informações relativas às equipes de saúde da família e às equipes de ACS foram obtidas a partir dos dados definitivos do cadastramento no Cadastro Nacional de Estabelecimentos de Saúde (CNES) do DATASUSMinistério da Saúde, 25 no Brasil, a ESF teve uma ampla expansão nos últimos anos, devido a um grande incentivo do Ministério da Saúde, o que corrobora os dados apresentados neste estudo para o Município do Rio de Janeiro. Ela é considerada a estratégia prioritária de reorientação da atenção primária e principal porta de entrada do SUS.…”

A perspectiva de egressos e de outros atores envolvidos sobre uma formação em serviços farmacêuticos na Atenção Primária à Saúde

“…No ano de 2009, houve expansão da APS no município do Rio de Janeiro (MRJ) por meio do aumento da cobertura da Estratégia Saúde da Família (ESF) 4 . Entre os desafios colocados, está a formação de grande número de profissionais em curto espaço de tempo, com o mínimo de prejuízo à oferta de serviços.…”

Spatial analysis of the cure rate for tuberculosis in primary health care in the municipality of Rio de Janeiro between 2012 and 2014

“…The Municipality of Rio de Janeiro (MRJ) had ESF coverage of approximately 7% up to 2008 [10] and only 3.55% coverage of full teams [11, 12]. As of 2009, the PHC reform began with expanded coverage to approximately 40% in 2012 and 46.16% in 2015, considering full teams [6, 10].…”