Performance evaluation of primary care services for the treatment of tuberculosis

Abstract

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.

Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city

“…Since there is criticism of the directly observed treatment alone (9)(10)(11) , we analyzed the DOTS strategy as a whole, and therefore, an implementation evaluation was obtained, on which one can discuss and identify the strengths and limitations for the success of the strategy.…”

“…Regarding the organizational context (partially implemented), we observed the prioritizing programmatic actions to the detriment of technical, political and financial autonomy, participation in the control of complementary incentives of DOTS, with transportation assistance and/or food aid. However, not enough enforcement actions alone (10) , the involvement of health workers in the service organization is necessary (14) . In inter-programmatic actions there is deficit of PTC integration with other areas, especially social services, with a percentage of consultations less than 50% of expected, reflecting the lack of interdisciplinary, which has recognized value in TB control (15) .…”

Care production for tuberculosis cases:analysis according to the elements of the Chronic Care Model

“…Studies (11)(12) show that the quantitative deficiency of professionals and the turnover of professionals within the services may generate work overload and care fragmentation to TB patients, thus affecting the problem-solving capacity of the services, the process of interaction with patients, and commitment and adherence to the treatment.…”

Perfil dos portadores de tuberculose em um município de Minas Gerais

“…O conhecimento de algumas características, como os métodos diagnósticos e a proporção de cura e abandono do tratamento, dos casos novos de TB notificados no município sugere que pode haver problemas de planejamento e no processo de trabalho dos serviços. Em outros municípios brasileiros, estudos semelhantes identificaram que as atividades de planejamento conjunto, entre coordenação do programa e unidades básicas, aconteciam de forma esporádica 9,10 . Desta forma, espera-se que, ao se tomar conhecimento dos resultados deste estudo, gestores e profissionais de saúde possam buscar melhores condições estruturais e de trabalho em prol de ações voltadas, especialmente, para o perfil identificado na tentativa alcançar os objetivos quanto à diminuição da magnitude da TB.…”