Organization of primary health care in pandemics

Abstract

Background: The world is experiencing one of the greatest public health emergencies in history with the global spread of COVID-19. Health systems, including Primary Health Care (PHC) services, are pillars of pandemic coping strategies. Objective: To systematic review of the literature that analyzes the effectiveness of PHC organization strategies in the context of epidemics. Methods: We performed a rapid systematic literature review on MEDLINE (via PubMed), EMBASE and LILACS (via VHL), in order to analyze empirical studies on the effectiveness of PHC organization strategies in the context of epidemics to improve access and reduce morbidity and mortality. There was no assessment of risk of bias, and the synthesis was narrative. PROSPERO CRD42020178310.Results: We selected seven articles, which studied the responses to different epidemic–s in different parts of the world. In terms of access, the studies suggest positive results with the adoption of adjustments of work processes of the teams and the structure of the services, combined with diversification of actions (including call center), adequate provision of inputs and personal protective equipment, adequate action plans and communication strategies, and effective integration with public health services and other levels of care. No study analyzed population morbidity and mortality. The included studies suggest also that community-oriented PHC is more effective in crisis scenarios, indicating the necessity of strengthening of the Family Health Strategy in the Brazilian context. Conclusion: PHC can be effective in coping with public health emergencies. Action plans should be built with broad participation by the actors involved in coping with the epidemic. Emphasis is placed on the importance of empowering the link between the healthcare service and its registered population.

The impact of the COVID-19 pandemic on primary care physicians and nurses in Nova Scotia: a qualitative exploratory study

“…Our results join with those of others 25 , 26 in supporting tailored policies to each community’s unique characteristics and needs, 25 particularly the needs of low income or rural populations. Primary care providers reported that provincial policies were insufficient in accounting for organizational and patient differences between communities and clinics during the pandemic.…”

Caracterización de mapeo de respuesta frente a la pandemia por Sars-CoV2 (Covid-19) en primer nivel de atención como medida de Salud Pública

“…Brasil tiene uno de los sistemas de salud universales más grandes del mundo, anclado en una extensa red de atención primaria de salud, pero que enfrenta problemas crónicos de financiación, gestión, suministro de personal y estructuración de servicios. 28 La APS es poderosa para reducir las inequidades en salud 29 y como lo refiere PerifaConnection (2020) citado por Sarti et al, (2020) 30 donde considera que la APS debe ser fortalecido y estructurado como una de las principales respuestas del sector salud a la epidemia, dado que está muy extendida en el territorio nacional y alcanza a importantes grupos de población expuestos a riesgos excesivos por sus condiciones de vida. Pandemias como la COVID-19 paralizan discursos y prácticas dirigidas a reducir el tamaño del Estado, flexibilizar las leyes laborales, desmantelar el sistema de protección social, menospreciar y reducir la inversión en ciencia, tecnología y educación, y socavar los servicios de salud pública.…”

Um Olhar Sobre a Autonomia: Percepções De Enfermeiras Sobre Suas Práticas Na Atenção Primária

“…(1) Nesse sentido, o bom funcionamento da APS objetiva superar o modelo hegemônico e promover uma assistência ampliada e integral à população. (2,3) Dentre os diversos campos profissionais que atuam no cotidiano dos serviços de saúde, a Enfermagem, representa hoje mais de 50% da força de trabalho do Sistema Único de Saúde, configurando-se assim em um dos pilares para a prática do cuidado. Em virtude das competências e habilidades desenvolvidas, as ações da enfermeira veem sendo decisivas no processo saúde-doença-cuidado ao considerar os determinantes sociais da saúde, iniquidades e condições crônicas, entre outros fatores que permeiam o bem-estar da população.…”