Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program

Abstract

Market-led economic reforms are usually viewed as being in conflict with

Comprehensive Primary Health Care in South America: contexts, achievements and policy implications

“…These changes in primary health care were part of a general surge of progressive social, economic and political reforms that provided further leverage for community autonomy, organization and participation, and led to increasing popular demands for government accountability. Brazil and Venezuela provide rich examples of bottom-up approaches with strong community participation and empowerment 18,34,38,40,41 that had a concrete effect on the formulation, implementation and evaluation of health policies and programs.…”

“…However, when accompanied by a transfer of power and resources to local communities its presence generally favored more comprehensive primary health care throughout the region, thus enabling better needs identification, priority assignment, decision-making and equitable resource distribution 26,49 . In the case of the health agents program in the State of Ceará, Brazil in the 1990s, for example, decentralization served to strengthen community capacity to voice local needs and interests and made primary health care and health services more accessible, equitable and culturally appropriate 41 (Figure 3).…”

“…One municipality in urban Chile showed strong intersectoral collaboration between the environment and education sectors in which formal local government support and informal personal contacts were important features of interventions 50 . The main obstacle to intersectoral action was the limited capacity of health systems, generally due to the following factors: segmentation and fragmentation of health systems; lack of coordination between health authorities, insurance organizations, levels of care and social services; incapacity of staff to work in an interdisciplinary fashion or across institutional boundaries 35,41 . In Argentina, primary health care delivery sites called Centros de Atención Primaria en Salud (CAPS) are well developed and serve as a good point of entry into the health system.…”

Integrating primary care and public health: learning from the Brazilian way

“…2,3 The Family Health Programme (recently renamed the Family Health Strategy) was developed as a universal, free at point of use, primary care service. The Family Health Programme is based on a very simple model -individual health units composed of a GP, a nurse, a nurse auxiliary and 4-6 lay community health workers (CHWs).…”

Múltiplos olhares sobre a mortalidade infantil no Ceará, Brasil

“…O Estado do Ceará tem chamado a atenção nacional e internacional pela luta contra a mortalidade infantil, recebendo do Fundo das Nações Unidas para a Infância (UNICEF) o Prêmio Maurice Pate 1 . Apesar da pobreza, doenças infecciosas, exclusão social 2 , violência hospitalar 3 e, até, homicídios de mulheres 4 , a taxa de mortalidade infantil diminuiu drasticamente de 166/1.000 nascidos vivos no final de 1960 5 para 16,2 em 2007 6 .…”