Measuring the quality of primary care in national health surveys: Lessons from Brazil.

Erno Harzheim,Lisiane Hauser,Luiz F Pinto,Otávio P D'Avila

doi:10.4102/phcfm.v12i1.2251

Abstract

BackgroundSouth Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until then the only one that had never used it in evaluation of primary health care facilities until 2015.AimThe authors aim to demonstrate that after the consolidation of Bresick’s team to an African version of PCAT, it had been adapted to household survey in Brazil.MethodsIn this letter, authors reflect on how Brazil had adapted PCAT to a national random household survey with Brazilian National Institute of Geography and Statistics (IBGE) – the Brazilian Census Bureau.ResultsIn the the beginning of 2019, Brazilian Ministry of Health brought back the PCAT as the official national primary health care assessment tool. Brazilian National Institute of Geography and Statistics (IBGE) included a new module (set of questions) in its National Health Survey (PNS-2019) and collected more than 100 000 households interviews in about 40% of the country’s municipalities. This module had 25 questions of the Brazilian validated version of the adult reduced PCAT.ConclusionWe believe that IBGE innovation with the Ministry of Health can encourage South Africa to establish a similar partnership with its National Institute of Statistics (Statistics South Africa) for the country to establish a baseline for future planning of primary health care, for decision-making based on scientific evidence.

Highlights

South Africa’s leadership in the use of Primary Care Assessment Tool on the African continentThe questionnaires that form what is known as the Primary Care Assessment Tool (PCAT) were originally created by the team led by Professors Barbara Starfield and Leiyu Shi of Johns Hopkins Bloomberg School of Public Health for the evaluation of essential and derived attributes of primary healthcare services.[1]In South Africa, between 2015 and 2019, Dr Bresick’s team adapted and cross-culturally validated the PCAT, measured primary healthcare performance in the Western Cape and described differences between the experiences of users and staff with regard to primary care.[2,3,4] This was the first time that PCAT was used in Africa
In Brazil, the same questions and domains proposed by Professors Barbara Starfield and Leiyu Shi were maintained in the child and adult PCAT versions.[6,7,8,9]
The new questions in the ZA PCAT help us to reflect on the widening scope of primary healthcare, such as the possibility of referring to a physiotherapist, a mental health professional, a dietician or a social worker

Summary

Background

South Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until the only one that had never used it in evaluation of primary health care facilities until 2015. Aim: The authors aim to demonstrate that after the consolidation of Bresick’s team to an African version of PCAT, it had been adapted to household survey in Brazil

Results

Conclusion

Introduction

Data availability statement