Abstract
This study aims to describe the adequacy of basic health units (UBS) in Brazil regarding structure and work process for obesity management and to evaluate user satisfaction with primary health care services. This cross-sectional study was conducted with data from the 2013-2014 National Program for Improving Primary Care Access and Quality (PMAQ) - an initiative to assess primary health care teams' performance. Data were collected between 2013 and 2014 through interviews with primary health care teams and users. All indicators of adequate care for obesity were defined within the article scope, based on data from the PMAQ. Of the 24,055 UBS analyzed, located in 4,845 different cities, only 7.6% had adequate structure for obesity management. Likewise, only 26.6% of the 114,615 users interviewed reported adequate access, and 27.8% of the UBS showed adequate service organization. Healthcare was considered as "good" or "very good" by 82.4% of users. These indicators varied according to geographic region, showing better results for the South and Southeast. Our results suggest that the country may still be at the initial stage of systematizing care with obesity, presenting significant disparities among regions.
Highlights
Obesity is a global issue, with an estimate of more than six hundred million adults witth obesity worldwide 1
We evaluated data from 24,065 primary health care (PHC) units of 4,845 Brazilian cities and 114,615 PHC users
Despite considerable advances 22, less than 1/4 of PHC units presented professionals on psychology, physical education, and nutrition – a markedly insufficient amount to meet the growing demand imposed by the obesity epidemic in the country. These findings indicate that obesity management within PHC units is still limited, impairing services credibility and the consolidation of initiatives focused on the PNAN 15,23,24
Summary
Obesity is a global issue, with an estimate of more than six hundred million adults witth obesity worldwide 1. In Brazil, the obesity rate increased by over 60% between 2006 and 2018, going from 11.8% to 19.8% 2. Obesity imposes an economic burden on individuals, families, countries, and healthcare systems [1,3]. Several countries around the globe have presented recommendations with a high level of evidence regarding the therapeutic assistance of overweight and individuals with obesity. A study aimed to evaluate and describe the quality of clinical guidelines for the treatment of obesity in adults from different countries identified 20 guidelines: nine from Europe, six from North America, three from Latin America, one from Asia, and one from Oceania 4. The practice of adequate nutrition therapies in primary and secondary healthcare leading to satisfactory outcomes remains rare in different countries and contexts 5
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