Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/45663 |
Resumo: | National Institute for Health Research (NIHR), Clinical Research Network North West London, Department of Health and Social Care - UK. |
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Medeiros, Olívia Lucena deBarreto, Jorge Otávio MaiaHarris, MatthewRusso, Letícia XanderSilva, Everton Nunes da2021-01-13T14:44:03Z2021-01-13T14:44:03Z2020MEDEIROS, Olívia Lucena de et al. Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil. Plos One, [San Franscisco], v. 15, n. 10, e0240631, p. 1-18, oct. 2020.1932-6203https://www.arca.fiocruz.br/handle/icict/4566310.1371/journal.pone.0240631National Institute for Health Research (NIHR), Clinical Research Network North West London, Department of Health and Social Care - UK.University of Brasilia. Graduate Program in Public Health. Brasilia, DF, Brazil / Ministry of Health. Brasilia, DF, Brazil.University of Brasilia. Graduate Program in Public Health. Brasilia, DF, Brazil / Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.Imperial College. Faculty of Medicine. School of Public Health. London, United Kingdom.State University of Maringá. Department of Economics. Maringá, PR, Brazil.University of Brasilia. Graduate Program in Public Health. Brasilia, DF, Brazil.Background: Improving access and quality in health care is a pressing issue worldwide and pay for performance (P4P) strategies have emerged as an alternative to enhance structure, process and outcomes in health. In 2011, Brazil adopted its first P4P scheme at national level, the National Programme for Improving Primary Care Access and Quality (PMAQ). The contribution of PMAQ in achieving the Sustainable Development Goals related to maternal and childcare remains under investigated in Brazil. Objective: To estimate the association of PMAQ with the provision of maternal and childcare in Brazil, controlling for socioeconomic, geographic and family health team characteristics. Method: We used cross-sectional quantile regression (QR) models for two periods, corresponding to 33,368 Family Health Teams (FHTs) in the first cycle and 39,211 FHTs in the second cycle of PMAQ. FHTs were analysed using data from the Brazilian Ministry of Health (SIAB and CNES) and the Brazilian Institute for Geography and Statistics (IBGE).Results: The average number of antenatal consultations per month were positively associated with PMAQ participating teams, with larger effect in the lower tail (10th and 25th quantiles) of the conditional distribution of the response variable. There was a positive association between PMAQ and the average number of consultations under 2 years old per month in the 10th and 25th quantiles, but a negative association in the upper tail (75th and 90th quantiles). For the average number of physician consultations for children under 1 year old per month, PMAQ participating teams were positively associated with the response variable in the lower tail, but different from the previous models, there is no clear evidence that the second cycle gives larger coefficients compared with first cycle. Conclusion: PMAQ has contributed to increase the provision of care to pregnant women and children under 2 years at primary healthcare level. Teams with lower average number of antenatal or child consultations benefited the most by participating in PMAQ, which suggests that PMAQ might motivate worse performing health providers to catch up.engPublic Library of SciencePregnancyPrenatal CareNational Health ProgramsPrimary Health CareInfant, NewbornHealth Services AccessibilityCross-Sectional StudiesPrimary health careMaternal health servicesChild healthNational health programsAtenção Primária à SaúdeServiços de Saúde MaternaSaúde da CriançaAssistência Integral à SaúdeGestantesProgramas Nacionais de SaúdeCuidado Pré-NatalDelivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.pt_BR.fl_str_mv |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil |
title |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil |
spellingShingle |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil Medeiros, Olívia Lucena de Pregnancy Prenatal Care National Health Programs Primary Health Care Infant, Newborn Health Services Accessibility Cross-Sectional Studies Primary health care Maternal health services Child health National health programs Atenção Primária à Saúde Serviços de Saúde Materna Saúde da Criança Assistência Integral à Saúde Gestantes Programas Nacionais de Saúde Cuidado Pré-Natal |
title_short |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil |
title_full |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil |
title_fullStr |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil |
title_full_unstemmed |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil |
title_sort |
Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil |
author |
Medeiros, Olívia Lucena de |
author_facet |
Medeiros, Olívia Lucena de Barreto, Jorge Otávio Maia Harris, Matthew Russo, Letícia Xander Silva, Everton Nunes da |
author_role |
author |
author2 |
Barreto, Jorge Otávio Maia Harris, Matthew Russo, Letícia Xander Silva, Everton Nunes da |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Medeiros, Olívia Lucena de Barreto, Jorge Otávio Maia Harris, Matthew Russo, Letícia Xander Silva, Everton Nunes da |
dc.subject.mesh.pt_BR.fl_str_mv |
Pregnancy Prenatal Care National Health Programs Primary Health Care Infant, Newborn Health Services Accessibility Cross-Sectional Studies |
topic |
Pregnancy Prenatal Care National Health Programs Primary Health Care Infant, Newborn Health Services Accessibility Cross-Sectional Studies Primary health care Maternal health services Child health National health programs Atenção Primária à Saúde Serviços de Saúde Materna Saúde da Criança Assistência Integral à Saúde Gestantes Programas Nacionais de Saúde Cuidado Pré-Natal |
dc.subject.en.pt_BR.fl_str_mv |
Primary health care Maternal health services Child health National health programs |
dc.subject.decs.pt_BR.fl_str_mv |
Atenção Primária à Saúde Serviços de Saúde Materna Saúde da Criança Assistência Integral à Saúde Gestantes Programas Nacionais de Saúde Cuidado Pré-Natal |
description |
National Institute for Health Research (NIHR), Clinical Research Network North West London, Department of Health and Social Care - UK. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2021-01-13T14:44:03Z |
dc.date.available.fl_str_mv |
2021-01-13T14:44:03Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
MEDEIROS, Olívia Lucena de et al. Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil. Plos One, [San Franscisco], v. 15, n. 10, e0240631, p. 1-18, oct. 2020. |
dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/45663 |
dc.identifier.issn.pt_BR.fl_str_mv |
1932-6203 |
dc.identifier.doi.none.fl_str_mv |
10.1371/journal.pone.0240631 |
identifier_str_mv |
MEDEIROS, Olívia Lucena de et al. Delivering maternal and childcare at primary healthcare level: the role of PMAQ as a pay for performance strategy in Brazil. Plos One, [San Franscisco], v. 15, n. 10, e0240631, p. 1-18, oct. 2020. 1932-6203 10.1371/journal.pone.0240631 |
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https://www.arca.fiocruz.br/handle/icict/45663 |
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eng |
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eng |
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Public Library of Science |
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Public Library of Science |
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