Abstract
BackgroundThis cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil.MethodsThe data source contained information on the infrastructure of the 233 Primary Health Units and on the work process of 266 health teams. The Principal Component Analysis for Categorical Data technique and the McNemar chi-squared statistical test for comparing paired samples were used, and a significance level of 5% with a 95% Confidence Interval was used.ResultsThe analysis identified a low proportion of dispensing of medications for the treatment of chronic disease in both cycles. There was a significant increase in seasonal influenza vaccination, in the number of sterilization, procedure, dressings and inhalation rooms. There was a small but significant reduction in the materials for cervical cancer screening, although they are available in almost 90.0% of the PHUs. More than 70.0% of the health teams carried out additional health education activities, encouraged physical activity, registered schoolchildren with health needs for monitoring, evaluated user satisfaction and user referral.ConclusionsThe findings of this study highlighted the improvement of the structure of the Primary Health Units, but identified a low provision of medicines to treat chronic diseases. The health promotion was performed as the main work process tool of family health teams, but it was little focused on intersectoral actions and on actions with the population in the area or on the empowerment of users through self-management support for chronic diseases. Furthermore, it is critical that the Family Health Strategy in Tocantins be organized and focused on the care of chronic diseases to improve and adapt itself to a primary chronic care model.
Highlights
This cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil
The aim of this study was to evaluate the adequacy of the structure of Primary Health Units (PHUs) and the work process of family health teams in the Family Health Strategy (FHS) according to the primary care model for Noncommunicable diseases (NCDs) and to examine the changes that occurred between the two cycles of external evaluations of the PMAQ-AB, which took place in 2012 and 2014, in the FHS of the state of Tocantins, Brazil
Descriptive analysis Additional file 1 shows the descriptive analysis of the 104 variables of Cycle 1 and the corresponding variables of Cycle 2 of the PMAQ-AB, which were used in this study to evaluate the adequacy of the structure and work process carried out in the FHS according to the primary care for NCDs and the changes that occurred between these two cycles in the state of Tocantins
Summary
This cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil. Premature deaths can be avoided by reducing the major modifiable risk factors, such as smoking, harmful alcohol use, unhealthy eating and physical inactivity [1]. The Plan proposes the strengthening of a health system directed toward integral care for people with NCDs. The Plan proposes the strengthening of a health system directed toward integral care for people with NCDs This plan especially includes the restructuring of Primary Health Care, the purpose of which is prevention, early detection, appropriate treatment, reduction of the main factors, risk management and the continued management of cases and people at high risk for major diseases; the goal of these aims is to prevent complications such as hospitalizations and premature deaths, as well as reduce financial expenses [5]
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