Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774 |
Resumo: | The study analyzes the structural characteristics of primary health care (PHC) in its contextual and organizational dimensions in remote rural municipalities (counties) in Northern Minas Gerais State, Brazil. This is a case study with a qualitative approach, using 21 semi-structured interviews with health system administrators and health care workers from the family health teams (EqSF), as well as secondary data. For the contextual dimension, the results show that socioeconomic factors in the remote rural municipalities condition the organization of PHC and leave the population vulnerable, especially in the rural areas of the remote municipalities. As for the organizational dimension, the principal characteristics are: coexistence of formal and informal assignment of the services’ users, two modalities of first-contact services, namely basic health units (UBS) and 24-hour health centers; prioritization of response to the spontaneous demand; strong action by the Family Health Support Centers in the development of activities in promotion and prevention, expanded scope of practices by community health workers; partial guarantee of transportation for persons in treatment; partial computerization of the UBS with the implementation of the electronic patient record (e-SUS), telecardiology; and the More Doctors Program. The study found that remote rural municipalities are not a uniform unit, since the municipal (county) seat and the rural areas are unequal in terms of living conditions and lack specific organization, policies, and financing to guarantee access to PHC. With all the limitations, the observations show initiatives with major difficulties in maintenance and sustainability and sometimes without necessarily corresponding to the use of space and social life that define rural health itineraries. |
id |
FIOCRUZ-5_1d6026d397d3acffe86e1ae0fbcd4060 |
---|---|
oai_identifier_str |
oai:ojs.teste-cadernos.ensp.fiocruz.br:article/7774 |
network_acronym_str |
FIOCRUZ-5 |
network_name_str |
Cadernos de Saúde Pública |
repository_id_str |
|
spelling |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, BrazilContexto e organização da atenção primária à saúde em municípios rurais remotos no Norte de Minas Gerais, BrasilPrimary Health CareRural HealthHealth Services AccessibilityAtenção Primária à SaúdeSaúde da População RuralAcesso aos Serviços de SaúdeThe study analyzes the structural characteristics of primary health care (PHC) in its contextual and organizational dimensions in remote rural municipalities (counties) in Northern Minas Gerais State, Brazil. This is a case study with a qualitative approach, using 21 semi-structured interviews with health system administrators and health care workers from the family health teams (EqSF), as well as secondary data. For the contextual dimension, the results show that socioeconomic factors in the remote rural municipalities condition the organization of PHC and leave the population vulnerable, especially in the rural areas of the remote municipalities. As for the organizational dimension, the principal characteristics are: coexistence of formal and informal assignment of the services’ users, two modalities of first-contact services, namely basic health units (UBS) and 24-hour health centers; prioritization of response to the spontaneous demand; strong action by the Family Health Support Centers in the development of activities in promotion and prevention, expanded scope of practices by community health workers; partial guarantee of transportation for persons in treatment; partial computerization of the UBS with the implementation of the electronic patient record (e-SUS), telecardiology; and the More Doctors Program. The study found that remote rural municipalities are not a uniform unit, since the municipal (county) seat and the rural areas are unequal in terms of living conditions and lack specific organization, policies, and financing to guarantee access to PHC. With all the limitations, the observations show initiatives with major difficulties in maintenance and sustainability and sometimes without necessarily corresponding to the use of space and social life that define rural health itineraries.Se analizan las características estructurales de la atención primaria a la salud (APS), en sus dimensiones de contexto y organizativas, en municipios rurales remotos de la Región del Norte de Minas Gerais, Brasil. Se trata de un estudio de caso con abordaje cualitativo, utilizándose 21 entrevistas semiestructuradas con gestores y profesionales de los equipos de salud de la familia (EqSF) y datos secundarios. Para la dimensión de contexto, los resultados muestran que bajo los municipios rurales remotos actúan condicionantes socioeconómicos que afectan la organización de la APS y vulnerabilizan a la población, sobre todo a la de las zonas rurales de los municipios rurales remotos. En relación con la dimensión organizativa, las principales características son: coexistencia de adscripción formal e informal de pacientes; de dos modalidades de servicios de primer contacto (unidades básicas de salud - UBS, y centros de salud 24 horas); priorización de la atención a la demanda espontánea; fuerte actuación del Núcleo de Apoyo a la Salud de la Familia para el desarrollo de actividades de promoción y prevención; alcance ampliado de prácticas del Agente Comunitario de Salud; garantía parcial de transporte para los usuarios; informatización parcial de las UBS con implantación del e-SUS; telecardiología; y el Programa Más Médicos. Este estudio revela que los municipios rurales remotos no son una unidad, visto que sede y zona rural son desiguales, en relación con las condiciones de vida, y además carecen de organización, políticas y financiación específicas para la garantía del acceso a la APS. Lo que se observa, con todas las limitaciones, son iniciativas municipales, con grandes dificultades para su mantenimiento y sostenibilidad y, a veces, sin la necesaria correspondencia con la utilización del espacio y vida social que definen los itinerarios sanitarios rurales.Analisam-se as características estruturais da atenção primária à saúde (APS), em suas dimensões de contexto e organizacional, em municípios rurais remotos da Região do Norte de Minas Gerais, Brasil. É um estudo de caso com abordagem qualitativa, utilizando-se 21 entrevistas semiestruturadas com gestores e profissionais das equipes de saúde da família (EqSF) e dados secundários. Para a dimensão de contexto, os resultados mostram que sob os municípios rurais remotos atuam condicionantes socioeconômicos que afetam a organização da APS e vulnerabilizam a população, sobretudo as das zonas rurais dos municípios rurais remotos. Em relação à dimensão organizacional, as principais características são: coexistência de adscrição formal e informal de clientela; duas modalidades de serviços de primeiro contato (unidades básicas de saúde - UBS, e centros de saúde 24 horas); priorização do atendimento à demanda espontânea; forte atuação do Núcleo de Apoio à Saúde da Família para o desenvolvimento de atividades de promoção e prevenção; escopo ampliado de práticas do agente comunitário de saúde; garantia parcial de transporte para os usuários; informatização parcial das UBS com a implantação do e-SUS; telecardiologia; e o Programa Mais Médicos. Este estudo revela que municípios rurais remotos não são uma unidade, visto que sede e zona rural são desiguais em relação às condições de vida e carecem de organização, políticas e financiamento específicos para a garantia do acesso à APS. O que se observa, com todas as limitações, são iniciativas municipais com grandes dificuldades para a manutenção e a sustentabilidade e, por vezes, sem a necessária correspondência à utilização do espaço e da vida social que definem os itinerários sanitários rurais.Reports in Public HealthCadernos de Saúde Pública2021-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774Reports in Public Health; Vol. 37 No. 11 (2021): NovemberCadernos de Saúde Pública; v. 37 n. 11 (2021): Novembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17372https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17373https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17374https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17375Patty Fidelis de AlmeidaAdriano Maia dos SantosLucas Manoel da Silva CabralMárcia Cristina Rodrigues Faustoinfo:eu-repo/semantics/openAccess2024-03-06T15:30:09Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/7774Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:08:56.279685Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil Contexto e organização da atenção primária à saúde em municípios rurais remotos no Norte de Minas Gerais, Brasil |
title |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil |
spellingShingle |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil Patty Fidelis de Almeida Primary Health Care Rural Health Health Services Accessibility Atenção Primária à Saúde Saúde da População Rural Acesso aos Serviços de Saúde |
title_short |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil |
title_full |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil |
title_fullStr |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil |
title_full_unstemmed |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil |
title_sort |
Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil |
author |
Patty Fidelis de Almeida |
author_facet |
Patty Fidelis de Almeida Adriano Maia dos Santos Lucas Manoel da Silva Cabral Márcia Cristina Rodrigues Fausto |
author_role |
author |
author2 |
Adriano Maia dos Santos Lucas Manoel da Silva Cabral Márcia Cristina Rodrigues Fausto |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Patty Fidelis de Almeida Adriano Maia dos Santos Lucas Manoel da Silva Cabral Márcia Cristina Rodrigues Fausto |
dc.subject.por.fl_str_mv |
Primary Health Care Rural Health Health Services Accessibility Atenção Primária à Saúde Saúde da População Rural Acesso aos Serviços de Saúde |
topic |
Primary Health Care Rural Health Health Services Accessibility Atenção Primária à Saúde Saúde da População Rural Acesso aos Serviços de Saúde |
description |
The study analyzes the structural characteristics of primary health care (PHC) in its contextual and organizational dimensions in remote rural municipalities (counties) in Northern Minas Gerais State, Brazil. This is a case study with a qualitative approach, using 21 semi-structured interviews with health system administrators and health care workers from the family health teams (EqSF), as well as secondary data. For the contextual dimension, the results show that socioeconomic factors in the remote rural municipalities condition the organization of PHC and leave the population vulnerable, especially in the rural areas of the remote municipalities. As for the organizational dimension, the principal characteristics are: coexistence of formal and informal assignment of the services’ users, two modalities of first-contact services, namely basic health units (UBS) and 24-hour health centers; prioritization of response to the spontaneous demand; strong action by the Family Health Support Centers in the development of activities in promotion and prevention, expanded scope of practices by community health workers; partial guarantee of transportation for persons in treatment; partial computerization of the UBS with the implementation of the electronic patient record (e-SUS), telecardiology; and the More Doctors Program. The study found that remote rural municipalities are not a uniform unit, since the municipal (county) seat and the rural areas are unequal in terms of living conditions and lack specific organization, policies, and financing to guarantee access to PHC. With all the limitations, the observations show initiatives with major difficulties in maintenance and sustainability and sometimes without necessarily corresponding to the use of space and social life that define rural health itineraries. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17372 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17373 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17374 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7774/17375 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html text/html application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 37 No. 11 (2021): November Cadernos de Saúde Pública; v. 37 n. 11 (2021): Novembro 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
_version_ |
1798943394771238912 |