Avaliação da estratégia saúde da família a partir das crenças dos profissionais

Abstract

As pesquisas de avaliação da Estratégia Saúde da Família funcionam como ferramenta de feedback nas decisões de seus gestores. Assim, o presente estudo objetivou avaliá-la a partir das crenças dos seus profissionais. Uma amostra probabilística de 337 profissionais respondeu à "Escala de Avaliação da Estratégia Saúde da Família pelos Profissionais", que investiga os seguintes fatores: 1) Recursos materiais (α=0,86); 2) Eficiência no atendimento (α=0,80); e 3) Infraestrutura física (α=0,73). Os resultados apresentaram uma avaliação positiva dos recursos materiais por 76,7% dos profissionais. A eficiência do atendimento foi avaliada negativamente por 53,4% dos participantes e a infraestrutura foi avaliada positivamente por 71,2% dos profissionais. Constatou-se ainda que todos os fatores foram pior avaliados pelos profissionais de nível médio/técnico. Conclui-se que existem aspectos positivos na estratégia, e que eles devem ser usados como modelos replicáveis, ressaltando-se, entretanto, entraves que minimizam sua eficácia e que precisam ser corrigidos objetivando melhorar as condições de prestação de serviço para seus usuários.

Primary health care as assessed by health professionals: comparison of the traditional model versus the Family Health Strategy

“…The FHS was ranked better overall and attained higher indexes only for four out of the eight attributes. These findings are in line with results of other investigations showing superior performance of the FHS on evaluation by health professionals or users 8,10,[12][13][14]23,24 . The performance of PHC as assessed by managers and health professionals could not be directly compared.…”

“…Efforts towards training health professionals of the FHS model, particularly health assistants, have been made by the Brazilian Ministry of Health 8 , perhaps explaining the differences observed in evaluations of this attribute by health assistants relative to general practitioners and nurses. Additionally, CHW is a category existing only in the FHS, and they are often responsible for facilitating contact and communication with families, providing information on risk factors, as well as health and social problems of their members 2 .…”

“…The performance of the PHC was measured by the PCATool designed for managers and health professionals 7,[16][17][18] . It contains approximately 100 questions, divided into eight attributes (accessibility, longitudinality, comprehensiveness, family focus, professional formation, first-contact, coordination and community orientation [7][8][9]12,16,17,21 ), containing a variable number of questions. Within each attribute, respondents must answer on an increasing six-point Likert-type scale ranging from 0 (never) to 5 (always), with the exception of two questions on the accessibility attribute which adopt a decreasing scale and must therefore be converted for analysis.…”

“…Based on evidence that high-quality PHC may have a positive impact on health indicators 7 , it follows that an innovative PHC model should provide better health outcomes. Comparative performance assessments of the FHS and traditional models by users, health professionals and managers have been carried out [8][9][10][11][12][13][14][15] . Quality-related key elements have been taken as a reference and adapted to the reality of the PHC in Brazil by validation with the Primary Care Assessment Tool (PCATool) 7,[16][17][18] .…”

Chronic and asymptomatic diseases influence the control of hypertension treatment in primary care

“…The relationship with the health team is paramount to establish favorable conditions for the involvement of the patient with their health problems; the contract of establishment in which are explicit rights and duties of both the patient and the professional can be a good strategy to do so. A study (16) which analyzed the efficiency of the care of the Family Health Strategy from beliefs of professionals showed that 53.4% rated the service negatively, emphasizing the need to modify or eliminate barriers in order to improve the conditions of service for its users.…”