Organização da atenção primária à saúde na pandemia de covid-19: revisão de escopo

Silva, Breno Ribeiro Gonçalves da; Correa, Ana Paula De Vechi; Uehara, Sílvia Carla da Silva André

doi:10.11606/s1518-8787.2022056004374

Rev. saúde pública

2022

DOI: 10.11606/s1518-8787.2022056004374

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Organização da atenção primária à saúde na pandemia de covid-19: revisão de escopo

Breno Ribeiro Gonçalves da Silva

Ana Paula De Vechi Correa

Sílvia Carla da Silva André Uehara

Abstract: OBJETIVO Mapear evidências científicas disponíveis sobre a organização dos serviços e profissionais da atenção primária à saúde durante o enfrentamento da covid-19. MÉTODO Trata-se de uma revisão de escopo, seguindo o método do Joanna Briggs Institute. Foram incluídos estudos publicados em português, espanhol e inglês, no período de janeiro/2020 a janeiro/2021, nas bases de dados CINAHL, Lilacs, Medline, PubMed e Web of Science. RESULTADOS Foram selecionados 24 artigos, que mostraram a reorganização dos serviç… Show more

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Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

Tavares,

Berra,

Alves

et al. 2024

Infect Dis Poverty

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Background Tuberculosis is one of the most significant infectious diseases for global public health. The reallocation of healthcare resources and the restrictions imposed by the COVID-19 pandemic have hindered access to TB diagnosis and treatment. Increases in unfavorable outcomes of the disease have been observed in Brazil. The objective of this study was to analyze the spatial distribution of unfavorable TB treatment outcomes in Brazil before and during the pandemic. Methods An ecological study with spatial analysis was conducted with all 5569 municipalities in Brazil. All reported cases of tuberculosis between January 2010 and December 2021, as well as reported cases of COVID-19 from February 2020 to December 2021, were included. The outcomes studied encompass loss to follow-up, drug-resistant tuberculosis, and death. The Getis Ord GI* technique was employed to assess spatial association, and the Kernel density estimator was used to identify areas with concentrated increases or decreases in outcomes. Bivariate Local Moran's I was used to examine the spatial association between outcomes and COVID-19 incidence. The study was approved by the Research Ethics Committee of Ribeirão Preto Nursing School, University of São Paulo. Results There were 134,394 cases of loss to follow-up, 10,270 cases of drug resistance, and 37,863 deaths. Clusters of high and low values were identified for all three outcomes, indicating significant changes in the spatial distribution patterns. Increases in concentrations were observed for lost to follow-up cases in the Southeast, while reductions occurred in the Northeast, South, and Midwest. Drug-resistant tuberculosis experienced an increase in the Southern and Southeastern regions and a decrease in the Northeast and South. TB-related deaths showed notable concentrations in the Midwest, Northeast, South, and Southeast. There was an increase in high occurrence clusters for deaths after 2020 and 2021 in the Northeast. Conclusions The pandemic has brought additional challenges, emphasizing the importance of enhancing efforts and disease control strategies, prioritizing early identification, treatment adherence, and follow-up. This commitment is vital for achieving the goal of tuberculosis elimination.

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Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

Tavares,

Berra,

Alves

et al. 2024

Infect Dis Poverty

View full text Add to dashboard Cite

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Gestão do trabalho e o cuidado na Atenção Primária à Saúde durante pandemia de COVID-19 no município de São Paulo (SP), Brasil

Anéas,

Lima,

Braga

et al. 2023

Ciênc. saúde coletiva

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Resumo O município de São Paulo historicamente foi marcado pela heterogeneidade da implementação pela coexistência de modelos conflitivos de gestão do SUS e de atenção na Atenção Primária à Saúde (APS). Consolidou-se a administração via contratos de gestão dos serviços de saúde, associada a uma lógica produtivista. Durante a pandemia de COVID-19, as fragilidades de uma APS seletiva tendem a ser pronunciadas. Assim, o presente artigo tem como objetivo analisar a gestão do trabalho e o cuidado na APS durante a pandemia de COVID-19 no município de São Paulo, em pesquisa qualitativa multicêntrica, ancorada no referencial teórico Paideia. Foram realizadas 31 entrevistas em profundidade com usuários e trabalhadores da APS e observação participante. Observou-se postura autoritária e gerencialista da gestão municipal na condução das respostas, com pouco espaço para escuta e diálogo. Notou-se enfraquecimento dos espaços coletivos e do vínculo entre serviço e comunidade; burocratização e precarização dos processos de trabalho e desmantelamento do NASF. Neste cenário, o cuidado caracterizou-se pela redução expressiva da clínica ampliada, compartilhada e pelo distanciamento das diretrizes da APS de base territorial e comunitária.

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Work management and care in Primary Health Care during the COVID-19 pandemic in the city of São Paulo (SP), Brazil

Anéas,

Lima,

Braga

et al. 2023

Ciênc. saúde coletiva

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The municipality of São Paulo has historically been marked by a heterogeneous implementation and coexistence of conflicting models of SUS management and Primary Health Care (PHC). The administration of health services management contracts was consolidated and associated with a productivist rationale. The selective PHC weaknesses tend to be pronounced during the COVID-19 pandemic. Thus, the present article aims to analyze work management and care in PHC during the COVID-19 pandemic in the municipality of São Paulo through a multicenter qualitative research anchored in the Paideia theoretical framework. We conducted 31 in-depth interviews with PHC clients and workers, along with participant observation. We noted the municipal management’s authoritarian and managerialist stance when conducting the responses, with little room for listening and dialogue. We identified weakened collective spaces and service-community bond, bureaucratization and precariousness of work processes, and NASF’s dismantling. In this setting, care was characterized by significantly reducing the expanded and shared clinical practice and the distancing from the territorial and community-based PHC guidelines.

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Organização da atenção primária à saúde na pandemia de covid-19: revisão de escopo

Cited by 5 publications

References 34 publications

Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

Gestão do trabalho e o cuidado na Atenção Primária à Saúde durante pandemia de COVID-19 no município de São Paulo (SP), Brasil

Work management and care in Primary Health Care during the COVID-19 pandemic in the city of São Paulo (SP), Brazil

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