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Quality of Primary Health Care in Brazil: advances, challenges and perspectives

ABSTRACT

The essay brings together advances, problems and proposals on the quality of Primary Health Care in Brazil, emphasizing the comprehensiveness of care, expressed in the completeness of health actions. Studies on access and quality of the Family Health Strategy (FHS) highlight advances in the expansion of population coverage and access of health actions, in the improvement of the structure of services, and provision of doctors. Structural problems persist, with emphasis on the availability of essential inputs and information and communication technologies. The organization and management of the services and of the professional practice of the teams suffer from a systemic problem of incompleteness of the offer of actions and health care, despite the references standards, guidelines, goals and protocols. We propose the universalization of FHS in Brazil with guarantees of investments in the structure of the services, complete team with doctors, nurses, dentists, nursing technicians and Community Health Agents with full dedication. Programs of continuous education, institutionalization of monitoring and evaluation practices in local teams and the accomplishment of 'quality collective efforts' stimulate the systemic improvement of the FHS in Brazil, contributing to the reduction of health inequalities.

KEYWORDS
Quality of health care; Primary Health Care; Family Health Strategy; Health policy; Health evaluation

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