Search

This study aims to analyze studies that evaluated the performance of Primary Health Care (PHC) services by using the Primary Care Assessment Tool (PCATool) under a worldwide user perspective. This is a systematic review that implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, from the following databases: Lilacs, Medline, SciELO, PubMed and the Coordination for the Improvement of Higher Education Personnel (CAPES) Journals Website, using descriptors Primary Care Assessment Tool and PCATool. Considering inclusion and exclusion criteria, we analyzed 22 research papers published from 2007 to 2015. The best-evaluated attributes were cultural competence, first contact use and longitudinality. On the other hand, the worst evaluated were first contact accessibility, family orientation, community orientation and comprehensiveness. Most of the health services evaluated were from Brazil, applied to "traditional" primary care clinic (UBS) and the Health Family Strategy (FHS). Services evaluated should strengthen structure and process components to achieve a better performance in PHC. [ABSTRACT FROM AUTHOR]

Introduction: Mobile health consists in applying mobile devices and communication capabilities for expanding the coverage and improving the effectiveness of health care programs. The technology is particularly promising for developing countries, in which health authorities can take advantage of the flourishing mobile market to provide adequate health care to underprivileged communities, especially primary care. In Brazil, the Primary Care Information System (SIAB) receives primary health care data from all regions of the country, creating a rich database for health-related action planning. Family Health Teams (FHTs) collect this data in periodic visits to families enrolled in governmental programs, following an acquisition procedure that involves filling in paper forms. This procedure compromises the quality of the data provided to health care authorities and slows down the decision-making process.Objectives: To develop a mobile system (GeoHealth) that should address and overcome the aforementioned problems and deploy the proposed solution in a wide underprivileged metropolitan area of a major city in Brazil.Methods: The proposed solution comprises three main components: (a) an Application Server, with a database containing family health conditions; and two clients, (b) a Web Browser running visualization tools for management tasks, and (c) a data-gathering device (smartphone) to register and to georeference the family health data. A data security framework was designed to ensure the security of data, which was stored locally and transmitted over public networks.Results: The system was successfully deployed at six primary care units in the city of Sao Paulo, where a total of 28,324 families/96,061 inhabitants are regularly followed up by government health policies. The health conditions observed from the population covered were: diabetes in 3.40%, hypertension (age >40) in 23.87% and tuberculosis in 0.06%. This estimated prevalence has enabled FHTs to set clinical appointments proactively, with the aim of confirming or detecting cases of non-communicable diseases more efficiently, based on real-time information.Conclusion: The proposed system has the potential to improve the efficiency of primary care data collection and analysis. In terms of direct costs, it can be considered a low-cost solution, with an estimated additional monthly cost of U$ 0.040 per inhabitant of the region covered, or approximately U$ 0.106 per person, considering only those currently enrolled in the system. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this paper we study the working conditions of Community Health Workers in performing house calls within low-income, violent communities in order to understand the challenges in delivering primary care in developing countries. We conducted field studies in two primary healthcare clinics and telephone surveys for 5 months in 2017 within systematic sample of 1690 community health workers based on clinics distributed along the health regions of the city of Rio de Janeiro, Brazil. A number of 759 interviews were completed, approximately 50% of the sample, 86% men and 14% women. Most participants are 30-39 years old (35%), followed by 27% of 40-49 years old participants. Results show that exposure to territorial violence and environmental or health-related diseases significantly affects CHWs. Moreover, CHWs have to develop a significant set of skills to cope with aspects of the territory, and those skills are not present in their training. As community health workers work on the sharp end of the healthcare system, responsible for outreaching, community education, counseling, and social support, our study presents contributions to government and management levels on working conditions inside communities, constraints in assistance, and difficulties in implementing primary care policies. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives. We evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. Methods. We collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. We performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. Results. We observed a statistically significant negative association between FHP coverage and infant mortality rate. After we controlled for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. Conclusions. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities. (Am J Public Health. 2008;99:87-93. doi: 10.2105/AJPH.2007.127480) [ABSTRACT FROM AUTHOR]