Users’ Perceptions of the Performance of the Family Health Strategy in the Greater Brasilia Area, Brazil

Abstract

In the 1990's, the Family Health Program was created in Brazil, later to be renamed a strategy because it was deemed to be a policy designed to organize and substitute the traditional health care model. The aim of this study was to verify the perceptions of users about the performance of the Family Health Strategy.This descriptive, exploratory study was undertaken at family health centers in different health districts in the greater Brasilia area: Gama, Santa Maria, Recanto das Emas, Samambaia, Planaltina, Paranoá and Itapoã. A Likertscale questionnaire ("Primary Care Assessment Tool") which had been previously validated in Brazil was answered by 372 users to assess the services provided.It was found that the best assessed domain was first contact, which received a mean score of 4.43, followed by longitudinality and quality of professionals, both with 3.84, then comprehensiveness (2.90) and coordination (2.25). The following domains received the lowest assessments: community orientation (mean score of 1.99), accessibility (1.97) and family-centeredness (1.81).It was concluded that the users of the family health program have relatively easy access to the health system, maybe because they manage to make their first appointments at the centers, which helps the continuity of contact with the service. Also, the quality of the professionals was deemed satisfactory. However, there is a problem with access to services at medium and high-complexity care levels (comprehensiveness) when necessary, which hampers the efficiency of coordination. Finally, it was found that family centeredness and community orientation, both essential to the success of the strategy, were limited.