Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355 |
Resumo: | The adequate fight against pandemics requires effective coordination between primary health care (PHC) and health surveillance, guaranteed attention to acute and chronic demands, and a bond with the community dimension in the scope of basic health units (UBS, acronym in Portuguese). This study aims to contrast two extreme standards of PHC performance in the fight against COVID-19 in Brazil, comparing them with the profiles of the corresponding municipalities and characteristics of the organization of services. Based on the results of a cross-sectional national survey with a representative sample of UBSs, we created a synthetic index to evaluate how PHC performs against COVID-19 called CPI, composed of axes of health surveillance and social support (collective dimension) and of COVID-19 care and continuity of care (individual dimension). Of the 907 surveyed UBSs, 120 were selected, half of which had the highest indexes (complete standard) and the other half, the lowest ones (restricted standard). The municipalities of the UBSs with a complete standard are predominantly rural, have low Municipal Health Development Index (MHDI), high Family Health Strategy (FHS) coverage, and stand out in the collective dimension, whereas the UBSs in urban municipalities with this same standard have high MHDI, low FHS coverage, and an emphasis on the individual dimension. In the restricted standard, we highlight community health workers’ reduced work in the territory. In the Brazilian Northeast, UBSs with complete standard predominate, whereas, in its Southeast, UBSs with restricted standard predominate. The study poses questions that refer to the role and organization of PHC in the health care network under situations that require prompt response to health issues and indicates the greater potential capacity of the FHS program in such situations. |
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Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrastsEstándares de desempeño de la atención primaria de salud frente al COVID-19 en Brasil: características y contrastesPadrões de desempenho da atenção primária à saúde diante da COVID-19 no Brasil: características e contrastesAtenção Primária à Saúde; Estratégia Saúde da Família; COVID-19; Vigilância em Saúde; Serviços de SaúdeAtención Primaria de Salud; Estrategia de Salud Familiar; COVID-19; Vigilancia en Salud; Servicios de SaludPrimary Health Care; Family Health Strategy; COVID-19; Public Health Surveillance; Health ServicesThe adequate fight against pandemics requires effective coordination between primary health care (PHC) and health surveillance, guaranteed attention to acute and chronic demands, and a bond with the community dimension in the scope of basic health units (UBS, acronym in Portuguese). This study aims to contrast two extreme standards of PHC performance in the fight against COVID-19 in Brazil, comparing them with the profiles of the corresponding municipalities and characteristics of the organization of services. Based on the results of a cross-sectional national survey with a representative sample of UBSs, we created a synthetic index to evaluate how PHC performs against COVID-19 called CPI, composed of axes of health surveillance and social support (collective dimension) and of COVID-19 care and continuity of care (individual dimension). Of the 907 surveyed UBSs, 120 were selected, half of which had the highest indexes (complete standard) and the other half, the lowest ones (restricted standard). The municipalities of the UBSs with a complete standard are predominantly rural, have low Municipal Health Development Index (MHDI), high Family Health Strategy (FHS) coverage, and stand out in the collective dimension, whereas the UBSs in urban municipalities with this same standard have high MHDI, low FHS coverage, and an emphasis on the individual dimension. In the restricted standard, we highlight community health workers’ reduced work in the territory. In the Brazilian Northeast, UBSs with complete standard predominate, whereas, in its Southeast, UBSs with restricted standard predominate. The study poses questions that refer to the role and organization of PHC in the health care network under situations that require prompt response to health issues and indicates the greater potential capacity of the FHS program in such situations.El enfrentamiento adecuado de las pandemias requiere una fuerte articulación entre atención primaria de salud (APS) y la vigilancia en salud, una atención garantizada a las demandas agudas y crónicas y la vinculación con la dimensión comunitaria en el ámbito de las unidades básicas de salud (UBS). El objetivo de este artículo es contrastar dos patrones extremos de desempeño de la APS en el enfrentamiento del COVID-19 en Brasil, comparándolos con los perfiles de los respectivos municipios y características de la organización de los servicios. A partir de los resultados de una encuesta nacional transversal con una muestra representativa de las UBS fue creado un índice sintético de desempeño de la APS frente al COVID-19, denominado CPI, compuesto por los ejes de vigilancia y apoyo social (dimensión colectiva) y de atención al COVID-19 y continuidad de la atención (dimensión individual). De las 907 UBS investigadas, se seleccionaron 120, siendo la mitad con los índices más grandes encontrados (estándar completo) y la otra con los más bajos (estándar estricto). Los municipios de las UBS con estándar completo son preponderantemente rurales, con bajo índice de desarrollo humano municipal (IDHM), alta cobertura de la Estrategia Salud de la Familia (ESF) y se destacan en la dimensión colectiva, mientras que las UBS en este mismo estándar situadas en municipios urbanos presentan alto IDHM, baja cobertura de ESF, con énfasis en la dimensión individual. En el estándar estricto, se destaca la reducida actuación de los agentes comunitarios de salud en el territorio. En la región Nordeste predominan las UBS con estándar completo, mientras que en el Sureste predominan las UBS con un estándar estricto. El estudio aporta cuestiones que remiten al papel y organización de la APS en la red de atención en situaciones que requieren respuesta rápida a los problemas de salud e indica una mayor capacidad potencial de la ESF en tales situaciones.O enfrentamento adequado de pandemias requer forte articulação entre atenção primária à saúde (APS) e vigilância em saúde, atenção garantida às demandas agudas e crônicas e vinculação com a dimensão comunitária no âmbito das unidades básicas de saúde (UBS). O objetivo deste artigo é contrastar dois padrões extremos de desempenho da APS no enfrentamento da COVID-19 no Brasil, cotejando-os com os perfis dos respectivos municípios e características da organização dos serviços. A partir dos resultados de inquérito nacional transversal com amostra representativa das UBS, foi criado um índice sintético de desempenho da APS em relação à COVID-19, denominado CPI, composto pelos eixos de vigilância e apoio social (dimensão coletiva) e de atendimento ao paciente com COVID-19 e continuidade do cuidado (dimensão individual). Das 907 UBS pesquisadas, foram selecionadas 120, sendo a metade com os maiores índices encontrados (padrão completo) e a outra com os menores (padrão restrito). Os municípios das UBS com padrão completo são preponderantemente rurais, com baixo Índice de Desenvolvimento Humano Municipal (IDHM), alta cobertura da Estratégia Saúde da Família (ESF) e destacam-se na dimensão coletiva, enquanto as UBS nesse mesmo padrão situadas em municípios urbanos apresentam alto IDHM, baixa cobertura de ESF, com ênfase na dimensão individual. No padrão restrito, destaca-se a reduzida atuação de agentes comunitários de saúde no território. Na Região Nordeste, predominam UBS com padrão completo, enquanto na Sudeste preponderam UBS com padrão restrito. O estudo apresenta questões que remetem ao papel e à organização da APS na rede de cuidados em situações que requerem pronta resposta aos agravos de saúde e indica maior capacidade potencial da ESF em tais situações.Reports in Public HealthCadernos de Saúde Pública2023-09-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355Reports in Public Health; Vol. 39 No. 8 (2023): AugustCadernos de Saúde Pública; v. 39 n. 8 (2023): Agosto1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZporenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355/18651https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355/18652https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355/18653Copyright (c) 2023 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessSchenkman, SimoneEmília Moraes Bousquat, AyleneAugusto Facchini, LuizRegina Rodrigues Gil, CéliaGiovanella, Lígia2023-09-05T16:51:14Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8355Revistahttps://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:2024-03-06T13:09:32.388259Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts Estándares de desempeño de la atención primaria de salud frente al COVID-19 en Brasil: características y contrastes Padrões de desempenho da atenção primária à saúde diante da COVID-19 no Brasil: características e contrastes |
title |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts |
spellingShingle |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts Schenkman, Simone Atenção Primária à Saúde; Estratégia Saúde da Família; COVID-19; Vigilância em Saúde; Serviços de Saúde Atención Primaria de Salud; Estrategia de Salud Familiar; COVID-19; Vigilancia en Salud; Servicios de Salud Primary Health Care; Family Health Strategy; COVID-19; Public Health Surveillance; Health Services |
title_short |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts |
title_full |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts |
title_fullStr |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts |
title_full_unstemmed |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts |
title_sort |
Performance patterns of primary health care in the face of COVID-19 in Brazil: characteristics and contrasts |
author |
Schenkman, Simone |
author_facet |
Schenkman, Simone Emília Moraes Bousquat, Aylene Augusto Facchini, Luiz Regina Rodrigues Gil, Célia Giovanella, Lígia |
author_role |
author |
author2 |
Emília Moraes Bousquat, Aylene Augusto Facchini, Luiz Regina Rodrigues Gil, Célia Giovanella, Lígia |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Schenkman, Simone Emília Moraes Bousquat, Aylene Augusto Facchini, Luiz Regina Rodrigues Gil, Célia Giovanella, Lígia |
dc.subject.por.fl_str_mv |
Atenção Primária à Saúde; Estratégia Saúde da Família; COVID-19; Vigilância em Saúde; Serviços de Saúde Atención Primaria de Salud; Estrategia de Salud Familiar; COVID-19; Vigilancia en Salud; Servicios de Salud Primary Health Care; Family Health Strategy; COVID-19; Public Health Surveillance; Health Services |
topic |
Atenção Primária à Saúde; Estratégia Saúde da Família; COVID-19; Vigilância em Saúde; Serviços de Saúde Atención Primaria de Salud; Estrategia de Salud Familiar; COVID-19; Vigilancia en Salud; Servicios de Salud Primary Health Care; Family Health Strategy; COVID-19; Public Health Surveillance; Health Services |
description |
The adequate fight against pandemics requires effective coordination between primary health care (PHC) and health surveillance, guaranteed attention to acute and chronic demands, and a bond with the community dimension in the scope of basic health units (UBS, acronym in Portuguese). This study aims to contrast two extreme standards of PHC performance in the fight against COVID-19 in Brazil, comparing them with the profiles of the corresponding municipalities and characteristics of the organization of services. Based on the results of a cross-sectional national survey with a representative sample of UBSs, we created a synthetic index to evaluate how PHC performs against COVID-19 called CPI, composed of axes of health surveillance and social support (collective dimension) and of COVID-19 care and continuity of care (individual dimension). Of the 907 surveyed UBSs, 120 were selected, half of which had the highest indexes (complete standard) and the other half, the lowest ones (restricted standard). The municipalities of the UBSs with a complete standard are predominantly rural, have low Municipal Health Development Index (MHDI), high Family Health Strategy (FHS) coverage, and stand out in the collective dimension, whereas the UBSs in urban municipalities with this same standard have high MHDI, low FHS coverage, and an emphasis on the individual dimension. In the restricted standard, we highlight community health workers’ reduced work in the territory. In the Brazilian Northeast, UBSs with complete standard predominate, whereas, in its Southeast, UBSs with restricted standard predominate. The study poses questions that refer to the role and organization of PHC in the health care network under situations that require prompt response to health issues and indicates the greater potential capacity of the FHS program in such situations. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-09-05 |
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/8355 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355/18651 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355/18652 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8355/18653 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/xml 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. 39 No. 8 (2023): August Cadernos de Saúde Pública; v. 39 n. 8 (2023): Agosto 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
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Fundação Oswaldo Cruz (FIOCRUZ) |
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FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
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Cadernos de Saúde Pública |
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Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943399377633280 |