Professional and community satisfaction with the Brazilian family health strategy

Abstract

Objective To analyze the strengths and limitations of the Family Health Strategy (ESF) from the perceptions of healthcare professionals and community. Methods Between June-August 2009, in the city of Vespasiano, Minas Gerais State, Southeastern Brazil, a questionnaire was applied to evaluate the ESF with 77 healthcare professionals and 293 caretakers of children under five. Health professional ESF training, community access to care, patient communication, and delivery of health education and pediatric care were of main interest in the evaluation. Logistic regression analysis was used to obtain odds ratios (OR) and 95% confidence intervals (CI). Results The majority of health care professionals reported their program training was insufficient in quantity, content and method of delivery. Caretakers and professionals identified similar weaknesses (services not accessible to the caretakers, lack of healthcare professionals, poor training for professionals) and strengths (community health worker-patient communications, provision of educational information, and pediatric care). Recommendations for improvement included: more doctors and specialists, more and better training, and scheduling improvements. Caretaker satisfaction with the ESF was found to be related to perceived benefits such as community health agent household visits (OR 5.8, 95%CI 2.8;12.1), good professional-patient relationships (OR 4.8, 95%CI 2.5;9.3), and family-focused health (OR 4.1, 95%CI 1.6;10.2); and perceived problems such as lack of personnel (OR 0.3, 95%CI 0.2;0.6), difficulty with access (OR 0.2, 95%CI 0.1;0.4), and poor quality of care (OR 0.3, 95%CI 0.1;0.6). Overall, 62% of caretakers reported being generally satisfied with the ESF services. Conclusions Identifying the limitations and strengths of the ESF from the healthcare professional and caretaker perspective may serve to advance primary community healthcare in Brazil.

Factors associated with user satisfaction regarding treatment offered in Brazilian primary health care

“…This study corroborates the studies of Arain et al 27 and Perez et al 15 . Santos et al 33 observed the following causes for satisfaction in Brazil: the good location of the FHS, a short distance from the FHS to the home, a short amount of time spent going to the FHS; and no need to use transport.…”

“…This high level of user satisfaction may be justified by the high amount of user satisfaction influencing factors that are directly related to humanized care ruled by the FHS. The influence of humanized care in user satisfaction has been observed in other studies 13,14,15,16 . Table 5 shows the logistic model fit in which 28 variables were directly associated with the outcome user satisfaction with primary health care services in Brazil.…”

“…This is an important scientific study because previous studies about user satisfaction with health services were conducted with restricted and localized populations 15,20,27,34,50 and previous studies that include questions related to user satisfaction using PMAQ-AB data were not based on statistical techniques for decision-making.…”

Satisfação do usuário da Atenção Básica em Saúde por regiões do Brasil: 1º ciclo de avaliação externa do PMAQ-AB

“…This result corroborates the study by Perez et al 22 in Vespasiano in the state of Minas Gerais (Brazil), who observed that difficulty in accessing the Family Health Strategy (FES) services decreased the likelihood of achieving user satisfaction with the services by 80%. In the study by Santos et al 23 in Santo Antônio do Monte in the state of Minas Gerais, the users indicated the following as reasons for their satisfaction: good location of the FES, short distance from home to the family health unit (FHU), short period of time spent travelling to the FHU, and the possibility to walk to the FHU.…”

Benefits of health reform for households in rural South Africa following implementation of ward-based primary healthcare outreach teams: a qualitative inquiry

“…These services are extended to the household level through regular visits to households. Household users of these services report high levels of overall satisfaction with services, displayed fewer symptoms when compared to those who only had access to the physician [7,8], and felt that they had been treated with respect and courtesy [9]. The family and community models of delivering PHC services have also been shown to reduce emergency department use, improve access to healthcare, enhance patient satisfaction, and improve patient health and quality of life [10,11].…”