Prevalence of health promotion programs in primary health care units in Brazil.

Luiz Roberto Ramos,Felipe Lobelo,Gregore Iven Mielke,Eduardo J Simoes,Alex Antonio Florindo,Deborah Carvalho Malta,Mário M Bracco,Pedro Curi Hallal,Diana C Parra,Grace Angélica De Oliveira Gomes

doi:10.1590/s0034-8910.2014048005249

Abstract

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system.METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units.RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did.CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.

Highlights

In the light of population aging and the consequent growing burden of non-communicable chronic diseases (NCDs), health promotion is a key public health strategy for tackling the NCD epidemic worldwide.a Epidemiological data have shown that, in 2008 in Brazil, a third of the general population reported at least one NCD.bWith the implementation of the universal health care model in Brazil – the Unified Health System (SUS), the Family Health Strategy (FHS) has been established as a crucial entry point to care for users into the health system
Our study showed that most primary care units have in place health promotion programs
Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil

Summary

METHODS

We conducted a cross-sectional study based on telephone interviews with managers of a randomly selected sample of PHCUs nationwide as part of the GUIA Project.[19]. We estimated the sample size assuming that each type of health promotion program would be available in 50.0% of the PHCUs, with a 95% confidence interval and 4 percent points of confidence limit. E The Government of Pernambuco in Brasil, have sponsored open spaces in the city of Recife, equipped for physical activity and with a professional available in the beginning and at the end of the day, free of charge for those attending. Available from: http://www2.recife.pe.gov.br/ projetos-e-acoes/projetos/academia-da-cidade/ f Project GUIA was a joint venture of American and Brazilian universities, sponsored by the CDC in Atlanta, that conducted several studies in Brazil concerning the promotion of physical activity, which led to the present study: a complete view of the project and its results. The study was approved by the national ethics research committee (Conselho Nacional de Ética em Pesquisa ‒ Protocol 16154, 2010)

RESULTS

CONCLUSIONS

INTRODUCTION

DISCUSSION