Improvement in Primary Care access and quality: the perspective of Community Health Workers

Garcia, Ana Claudia Pinheiro; Andrade, Maria Angélica Carvalho; Lima, Eliane de Fátima Almeida; Rocha, Érika Maria Sampaio; Lima, Rita de Cássia Duarte

doi:10.1590/0103-1104201811805

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ORIGINAL ARTICLE • Saúde debate 42 (118) • Jul-Sep 2018 • https://doi.org/10.1590/0103-1104201811805 copy

Improvement in Primary Care access and quality: the perspective of Community Health Workers

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The study aimed to describe how the participation of Community Health Workers (CHW) took place in the National Program for Access and Quality Improvement in Primary Care (PAQI-PC), and to evaluate their perspective regarding improvements in both the access and the quality of Primary Care (PC). This is a descriptive, cross-sectional study with quantitative approach, carried out with 133 CHWs linked to family health teams that joined the program. Results pointed out the need of greater efforts by municipalities to encourage the involvement of CHWs in evaluation processes and to improve their training, aiming at adjusting their level of apprehension and awareness of both the access and the quality in primary care.

KEYWORDS
Community Health Workers; Primary Health Care; Health policy; Family health; Health evaluation

Variables	N	%
Is aware of PMAQ-AB
Yes	102	76,7
No	24	18,0
Ignored	07	5,3
Is aware of PMAQ-AB purposes
Yes	91	68,4
No	13	9,8
Ignored	05	4,5
Was informed about the team's adherence to PMAQ-AB
Yes	94	70,7
No	29	21,8
Ignored	10	7,5
Was invited to participate in the team's self-evaluation phase
Yes, and I did participate	68	51,1
Yes, but I did not participate	13	9,8
No	45	33,8
Ignored	07	5,3
During the external evaluation phase, your collaboration was required
Yes, to help answering the questionnaire	41	30,8
Yes, to find documents/corroborating evidence	09	6,8
Yes, to help answering the questionnaire and to find documents/ corroborating evidence	23	17,3
My collaboration was not required	54	40,6
Ignored	06	4,5
You think that professionals who do not have upper education should also participate in PMAQ-AB external evaluation phase
Yes	115	86,5
No	11	8,3
Ignored	07	5,3
Did you observe improvements in access to Primary Care from PMAQ onin the unit you work at
Yes, many improvements	11	8,3
Yes, some improvements	49	36,8
No, no improvements	64	48,1
Ignored	09	6,8
Did you observe improvements in the quality of Primary Care from PMAQ onin the unit you at
Yes, many improvements	13	9,8
Yes, some improvementes	51	38,3
No, no improvements	61	45,9
Ignored	08	6,0

Variables	N	%
Improvements in access	N=60
Increased number of booked appointments	26	43,3
Improvement/ expansion in users' active search	21	35,0
Increased number of home visits	17	28, 3
Attendance of spontaneous demands	14	23,3
Reduction of waiting time for appointments	13	21,7
Enlargement/modification of attendance hours	8	13,3
Increased number of medicines released	4	6,7
Increased availability of equipment and materials	-	-
Improvements in quality	N=64
In appointments with doctor and/or nurses	36	56,2
In attendance to pregnant women	36	56,2
In child care appointments	30	46,9
In home visits	27	42,2
In the team's work process	23	36,0
In appointments booking	20	31,2
In booked appointments with dentists	19	29,7
In attendance to tuberculosis and Hansen disease patients	18	28,1
In immunization	17	26,6
In access to medical records	13	20,3
In signalization of the units' rooms	10	15,6
In medicines release	10	15,6
In the users's booking for specialized appointments	10	15,6
In matrix support	8	12,5
In the units' facilities	5	7,8
In institutional support	-	-

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E-mail: revista@saudeemdebate.org.br

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[1] Conflict of interest: non-existent