Abstract
This paper analyzes the results of an evaluative study in the city of Manaus, Amazonas State, Brazil, on primary health care for patients with hypertension and/or diabetes. The ethnographic approach used access to services and comprehensiveness of health care as core analytical categories, comparing the health practices developed by Family Health Program (FHP) units with traditional non-FHP primary care units. Access to family health care units in low-income communities is limited by the precarious surrounding urban infrastructure. The main barrier to access to primary care units is distance. The lack of a referral system between the various levels of complexity jeopardizes patients' access to tests and specialists. The care supplied by the two units is limited to patient conditions that can be treated pharmacologically, thus compromising the comprehensiveness of care. The health professionals display a limited capacity to hear problems outside the immediate focus of the program activity. The paper highlights the potential for using ethnography in evaluative research on health systems and services.
Highlights
This paper analyzes the results of an evaluative study in the city of Manaus, Amazonas State, Brazil, on primary health care for patients with hypertension and/or diabetes
The ethnographic approach used access to services and comprehensiveness of health care as core analytical categories, comparing the health practices developed by Family Health Program (FHP) units with traditional non-FHP primary care units
A hipertensão arterial sistêmica e o diabetes mellitus são agravos independentes e freqüentemente sinérgicos cuja combinação redunda em grave comprometimento à saúde
Summary
This paper analyzes the results of an evaluative study in the city of Manaus, Amazonas State, Brazil, on primary health care for patients with hypertension and/or diabetes. Os dados que dão origem a este artigo são parte dessa pesquisa de linha de base, produzidos a partir de uma etnografia das práticas sanitárias da atenção pré-natal e do programa de controle da hipertensão e do diabetes mellitus (HIPERDIA) na rede básica do Município de Manaus.
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