The Brazilian primary health care response to the COVID-19 pandemic: individual and collective approaches

Aylene Bousquat; Ligia Giovanella; Luiz Facchini; Maria Helena Magalhaes Mendonça; Fulvio Borges Nedel; Geraldo Cury; Paulo Henrique Dos Santos Mota; Simone Schenkman; Patricia Sampaio Chueiri; Maria Cecilia Goi Porto Alves

doi:10.3389/fpubh.2023.1212584

The Brazilian primary health care response to the COVID-19 pandemic: individual and collective approaches

Front Public Health. 2023 Dec 8:11:1212584. doi: 10.3389/fpubh.2023.1212584. eCollection 2023.

Affiliations

¹ Department of Politics, Management and Health, Faculty of Public Health, University of São Paulo, São Paulo, Brazil.
² National School of Public Health (ENSP), Rio de Janeiro, Brazil.
³ Department of Social Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil.
⁴ Department of Public Health, Federal University of Santa Catarina, Florianopolis, Brazil.
⁵ Department of Social and Preventive Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
⁶ Faculdade Israelita de Ciências da Saúde Albert Einstein Hospital Israelita Albert Einstein, São Paulo, Brazil.
⁷ Department of Health, Institute of Health, Government of the State of São Paulo, Institute of Health, São Paulo, Brazil.

Abstract

Objectives: Brazil's PHC wide coverage has a potential role in the fight against COVID, especially in less developed regions. PHC should deal with COVID-19 treatment; health surveillance; continuity of care; and social support. This article aims to analyze PHC performance profiles during the pandemic, in these axes, comparing the five Brazilian macro-regions.

Methods: A cross-sectional survey study was carried out, using stratified probability sampling of PHC facilities (PHCF). A Composite Index was created, the Covid PHC Index (CPI). Factor analysis revealed that collective actions contrastingly behaved to individual actions. We verified differences in the distributions of CPI components between macro-regions and their associations with structural indicators.

Results: Nine hundred and seven PHCF participated in the survey. The CPI and its axes did not exceed 70, with the highest value in surveillance (70) and the lowest in social support (59). The Individual dimension scored higher in the South, whereas the Collective dimension scored higher in the Northeast region. PHCF with the highest CPI belong to municipalities with lower HDI, GDP per capita, population, number of hospitals, and ICU beds.

Conclusion: The observed profiles, individually and collectively-oriented, convey disputes on Brazilian health policies since 2016, and regional structural inequalities.

Keywords: Brazil; COVID-19 pandemic; family health; health services; health survey; primary health care.

Publication types

Research Support, Non-U.S. Gov't
Comment

MeSH terms

Brazil / epidemiology
COVID-19 Drug Treatment
COVID-19* / epidemiology
Cross-Sectional Studies
Humans
Pandemics
Primary Health Care

Grants and funding

The study as supported by Umane Foundation and Pan American Health Organization (PAHO). This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.