Primary health care in the 25 years of Journal Ciência &amp; Saúde Coletiva

Bousquat, Aylene; Medina, Maria Guadalupe; Mendonça, Maria Helena Magalhães de; Almeida, Patty Fidelis de; Aquino, Rosana; Santos, Alaneir de Fátima dos; Giovanella, Ligia

doi:10.1590/1413-812320202512.23342020

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ARTICLE • Ciênc. Saúde Colet. 25 (12) • Dec 2020 • https://doi.org/10.1590/1413-812320202512.23342020 copy

Primary health care in the 25 years of Journal Ciência & Saúde Coletiva

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Primary Health Care (PHC) is an area of study that has improved remarkably in the last decades. In Brazil, this academic production is highly expressed in the field of Collective Health. This paper aims to analyze the PHC production published in the first 25 years of the “Journal Ciência & Saúde Coletiva” (C&SC). A narrative review was carried out, with analysis of the themes, methods, scale of analysis, partnerships, and authorship. A total of 295 papers were published, which corresponds to 5.9% of the total publications. A growing trend in papers addressing PHC was observed. The studies were mostly empirical (78.6%), with a qualitative approach (58.0%) and were predominantly local or municipal. Studies on health professionals were more frequent. The three prevailing themes were the health care model, PHC performance or effectiveness, and the work process. The profile found dialogues with the rich and diverse experience of Brazilian PHC. However, the incorporation of broader analyses is still challenging. The published papers highlighted the debates and contributed to the reflection and dissemination of the experience of Brazilian PHC, which was and is central to the construction of the Brazilian Health System.

Key words:
Primary Health Care; Bibliometrics; Periodicals as topic

Theme	Details
Care model	Approach to aspects related to technological arrangements for the provision of care in PHC; establishing relations between services; in articulating PHC with other sectors and multidisciplinary support. Analysis of PHC attributes, such as comprehensiveness, longitudinality and family and community orientation, were also included.
PHC performance or effectiveness	Analysis of process or result indicators, including user satisfaction, to assess the degree of implementation of PHC actions or the quality of the teams' work performance or their effectiveness.
Work process	Characteristics of health practices, their organization, and the attributions and role of professionals working in PHC.
Health management	Approach to the capacity of government, profile, competencies, and health managers' practices and use of management technologies, including social participation.
Training and Continuing Education	Issues related to training and continuing education for team professionals, including profile assessment and skills analysis, and appreciation of specialization courses and professional master's degrees.
Policy analysis	Analysis of the formulation or implementation of the PHC policy, as a whole, or one of its components.
Access, accessibility, coverage, and use of services	Evaluation of access, accessibility, coverage, and use of services, whether from the perspective of users or professionals and managers or through health indicators.
Reform of other health systems	Analysis of health system reforms with a focus on PHC in other countries.
PHC articulation in health care networks	Articulation of PHC with other levels of the health service system, lines of care, and construction of care networks.
Perception of illness and care processes	Perception of health professionals and users about the health-disease and care processes and the social representations in the health-disease process.
Users’ profile	Characterization of the profile of PHC users.
Health promotion	Approach to actions, proposals, and programs related to health promotion within PHC.
Work management	Forms of management of the work process, labor division, and communication, insertion, and remuneration policy, and turnover of PHC professionals and PHC workers' health surveillance actions.
Financing, costs, and application of resources	PHC financing, costs of actions and services, financial incentives, and application of resources for health actions.
Health Education	Analysis of educational practices, including the representations of health professionals about these practices.
Family	Conceptions and reflections on the family and discussing instruments for its approach.

Characteristics		No.	%
Approach (n = 295)	Qualitative	171	58.0
	Quantitative	106	35.9
	Qualitative/quantitative	18	6.1
Type of Study (n = 295)	Empirical	232	78.6
	Essay, Debate, and Opinion	55	18.6
	Review	8	2.7
Scope of Empirical Studies (n = 232)	Local (UBS)	47	20.3
	Municipalities/Districts	111	47.8
	Region	15	6.5
	State	19	8.2
	Large Regions/National	26	11.2
	International	15	6
Subjects (n = 232)	Professionals	77	33.2
	Users	40	17.2
	Managers	22	9.5
	Professionals and managers	15	6.5
	User, professional and manager	10	4.3
	User and professional	8	3.4
	Other	4	1.8
	Unspecified	56	24.1
Institutions involved (n = 295)	One	121	41.0
	Two or more	174	59.0
Federated Units	One	220	74.6
	Two or more	71	24.1
	Unspecified	4	1.3

Theme	All		Empirical and Reviews		Essays, debates, and opinion
Theme	N	%	N	%	N	%
Care model	54	18.3	40	16.7	14	25.5
PHC performance or effectiveness	50	17.0	49	20.4	1	1.8
Work process	45	15.3	36	15.0	9	16.4
Health management	27	9.2	22	9.2	5	9.1
Training and Continuing Education	22	7.5	20	8.3	2	3.6
Policy analysis	17	5.8	5	2.1	12	21.8
Access, coverage, and use	14	4.8	14	5.8	0	0.0
Reform of other health systems	12	4.1	8	3.3	4	7.3
PHC in Networks and Regions	10	3.4	8	3.3	2	3.6
Perception of illness and care	9	3.1	9	3.8	0	0.0
Users’ profile	8	2.7	7	2.9	1	1.8
Health promotion	8	2.7	6	2.5	2	3.6
Work management	7	2.4	7	2.9	0	0.0
Financing, costs, and application	6	2.0	5	2.1	1	1.8
Health education	4	1.4	4	1.7	0	0.0
Family	2	0.7	0	0.0	2	3.6
Total	295	100.0	240	100.0	55	100.0

Subtheme	N	%
Health professionals	38	16.7
Community Health Workers	19	8.4
Other professionals	19	8.4
Mais Médicos (More Doctors) Program	18	7.9
Work process aspects	9	4.0
Interdisciplinary team and teamwork	6	2.6
Other (care practices, light technologies, and professional turnover)	4	1.8
Specialization and Master	3	1.3
Contracting and other forms of work management	5	2.2
Incentive programs	5	2.2
Health disorders and problems	22	9.7
Chronic diseases	8	3.5
PCSH	6	2.6
Other (Tobacco control, dengue, tuberculosis, people with disabilities, Down syndrome, violence)	8	3.5
Program areas	68	30.0
Oral Health	18	7.9
Child and Maternal and Child Health	12	5.3
Men’s Health	7	3.1
Elderly Health	7	3.1
Pharmaceutical care	6	2.6
Integrative and Complementary Practices	5	2.2
Others	13	5.7
Care model approaches	24	10.6
Health Surveillance and social participation	8	3.5
Multidisciplinary support	7	3.1
Other	9	4.0
Evaluation, Monitoring and Information Systems and Technologies	10	4.4
International health	12	5.3
Portugal	5	2.2
Other countries	7	3.1
Other	12	5.3
Total	227	100

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[1] Collaborations

A Bousquat, MG Medina, MHM Mendonça, PF Almeida, R Aquino, AF Santos and L Giovanella participated equally in all stages of preparation of the article.