Time trend of Family Health Strategy coverage in Brazil, its Regions and Federative Units, 2006-2016

Neves, Rosália Garcia; Flores, Thaynã Ramos; Duro, Suele Manjourany Silva; Nunes, Bruno Pereira; Tomasi, Elaine

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 27 (3) • 2018 • https://doi.org/10.5123/S1679-49742018000300008 copy

Time trend of Family Health Strategy coverage in Brazil, its Regions and Federative Units, 2006-2016

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the Family Health Strategy (FHS) coverage time trend in Brazil, its Regions and Federative Units (FUs) in 2006-2016.

Methods:

this was an ecological study with time series analysis of Ministry of Health Primary Care Department data; Prais-Winsten regression was used.

Results:

FHS coverage in Brazil in 2006 and 2016 was 45.3% and 64.0%, respectively, with an increasing trend of coverage (annual variation = 8.4%: 95%CI 7.4;9.3); all five regions showed an increasing trend in coverage, as did the majority of FUs, with the exception of Roraima, Amapá, Piauí, Rio Grande do Norte and Paraíba, which showed stability; in 2016, 14 FUs had coverage of between 75 and 100%, and 11 had coverage of between 50 and 74,9%; coverage in São Paulo and Federal District was below 50%.

Conclusion:

although, overall, FHS coverage increased, 13 FUs presented coverages below 75% in 2016; therefore, more efforts are needed to universalize coverage.

Keywords:
Family Health; Health Services Coverage; Primary Health Care; Time Series Studies

Regions and Federative Units	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	Annual variation^b %(95% CI)^c	P- value^d	Trend
North	40.7	42.0	45.7	49.2	51.4	51.6	51.1	52.0	57.3	61.9	63.4	10.3 (7.5;13.1)	<0.001	Increasing
Acre	59.9	58.0	59.4	63.6	61.1	60.6	66.3	69.8	73.8	77.2	79.7	7.4 (4.4;10.3)	<0.001	Increasing
Amapá	54.4	57.0	61.7	68.9	73.8	69.8	58.2	56.9	68.1	70.8	73.4	5.5 (-1.5;13.0)	0.116	Stationary
Amazonas	43.2	45.5	48.5	49.9	51.1	48.6	47.7	48.7	54.6	59.4	58.4	6.5 (2.8;10.5)	0.004	Increasing
Pará	28.8	30.4	34.6	38.1	40.5	41.7	42.3	43.3	47.0	52.3	54.5	15.3 (11.9;18.8)	<0.001	Increasing
Rondônia	36.4	38.8	45.7	50.3	55.5	58.5	58.8	60.9	66.5	73.2	76.6	18.3 (14.1;22.6)	<0.001	Increasing
Roraima	72.5	67.7	69.3	72.1	69.1	67.2	64.8	56.1	72.4	72.7	76.2	0.3 (-4.4;5.3)	0.828	Stationary
Tocantins	77.0	76.0	76.5	85.2	88.4	88.4	82.8	84.8	91.7	92.9	93.1	4.7 (2.3;7.2)	0.002	Increasing
Northeast	65.8	66.7	69.7	69.7	70.0	72.0	72.5	73.8	78.1	79.3	80.0	4.6 (3.8;5.5)	<0.001	Increasing
Alagoas	68.7	69.2	70.1	70.6	72.1	71.8	72.4	73.2	75.2	75.7	76.5	2.5 (2.2;2.9)	<0.001	Increasing
Bahia	49.8	50.1	53.6	53.8	57.7	60.4	62.0	63.7	68.6	70.4	72.4	9.7 (9.2;10.2)	<0.001	Increasing
Ceará	58.6	65.0	66.5	66.6	69.0	70.1	69.4	70.8	78.1	80.7	81.0	6.8 (4.9;8.7)	<0.001	Increasing
Maranhão	73.5	72.7	77.4	79.0	80.7	79.1	76.6	77.4	81.9	83.2	80.2	2.2 (0.5;4.0)	0.018	Increasing
Paraíba	91.1	91.9	94.5	94.7	95.3	93.2	92.5	92.9	93.8	91.9	94.2	0.3 (-0.6;1.2)	0.497	Stationary
Pernambuco	62.4	62.0	66.5	67.1	68.0	68.3	68.3	70.0	74.1	75.8	76.9	4.9 (3.7;6.0)	<0.001	Increasing
Piauí	95.2	94.8	96.0	96.9	97.4	96.7	94.2	96.1	96.9	97.0	98.7	0.6 (-0.1;1.3)	0.085	Stationary
Rio Grande do Norte	79.1	76.4	79.4	77.9	77.4	76.2	74.9	78.6	82.1	82.1	82.0	1.1 (-0.8;2.9)	0.218	Stationary
Sergipe	82.3	82.7	83.2	85.2	86.2	85.1	84.0	83.4	89.1	87.8	87.8	1.5 (0.6;2.4)	0.005	Increasing
Southeast	33.3	33.9	36.0	37.3	39.1	41.0	43.6	44.5	48.3	51.3	53.1	11.8 (11.0;12.6)	<0.001	Increasing
Espírito Santo	45.4	44.5	47.5	48.9	51.0	52.1	52.3	53.5	58.4	60.7	60.3	7.6 (6.4;8.8)	<0.001	Increasing
Minas Gerais	57.4	58.6	61.6	63.8	66.7	68.8	70.6	70.9	75.4	78.2	79.1	7.9 (7.2;8.6)	<0.001	Increasing
Rio de Janeiro	27.9	28.0	30.0	30.3	32.3	37.1	42.9	44.8	47.1	48.9	52.0	16.7 (12.9;20.7)	<0.001	Increasing
São Paulo	22.8	23.5	25.1	26.1	27.3	28.3	30.4	31.0	35.0	38.7	40.7	14.2 (11.6;16.9)	<0.001	Increasing
South	44.1	44.4	46.5	48.2	49.8	51.0	52.9	55.3	60.1	64.6	66.5	10.1 (8.0;12.2)	<0.001	Increasing
Paraná	48.2	48.1	50.0	51.6	53.5	55.0	56.5	58.5	63.5	66.8	67.4	8.6 (7.1;10.1)	<0.001	Increasing
Rio Grande do Sul	29.5	30.3	32.4	33.9	35.5	36.3	38.8	41.3	47.0	53.5	57.2	16.4 (12.1;20.8)	<0.001	Increasing
Santa Catarina	64.1	64.1	66.3	68.1	69.2	69.9	71.0	73.6	76.8	79.8	80.4	5.6 (4.6;6.6)	<0.001	Increasing
Midwest	44.8	44.8	47.4	49.0	51.9	52.9	53.7	55.5	58.6	60.2	60.9	7.9 (7.2;8.7)	<0.001	Increasing
Federal District	6.9	5.8	6.0	10.1	13.6	15.4	16.4	23.7	28.8	31.1	31.1	53.8 (40.6;68.2)	<0.001	Increasing
Goiás	55.1	54.6	56.8	56.9	59.7	61.2	62.6	63.0	65.4	66.6	67.1	5.4 (4.9;5.8)	<0.001	Increasing
Mato Grosso	53.0	52.3	56.3	60.2	63.3	62.7	61.2	61.0	63.8	65.3	66.7	5.3 (2.6;8.1)	0.001	Increasing
Mato Grosso do Sul	47.6	50.6	54.8	57.5	59.8	60.3	62.1	63.9	66.8	68.7	69.7	8.9 (6.9;11.0)	<0.001	Increasing
Brazil	45.3	46.0	48.5	49.8	51.8	53.0	54.3	55.6	59.8	62.5	64.0	8.4 (7.4;9.3)	<0.001	Increasing

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Rosália Garcia Neves - Rua Vitor Valpirio No. 34, apto. 304, Centro, Pelotas, RS, Brazil. CEP: 96020-250. E-mail: rosaliagarcianeves@gmail.com