Reform movements in the Federal District Health Care System:conversion of the Primary Health Care assistance model

• Published in: Ciência & saude coletiva Vol. 24; no. 6; pp. 2031 - 2041
• Main Authors: Corrêa, Daniel Seabra Resende Castro, Moura, Alexandra Gouveia de Oliveira Miranda, Quito, Marcus Vinícius, Souza, Heloiza Machado de, Versiani, Luciana Martins, Leuzzi, Sérgio, Gottems, Leila Bernarda Donato, Macinko, James
• Format: Journal Article
• Language: English
• Published: Brazil Associacao Brasileira de Pos-Graduacao em Saude Coletiva - ABRASCO 01-06-2019; Associação Brasileira de Saúde Coletiva
• Subjects: Brazil; Conversion; Delivery of Health Care - organization & administration; Family Health; Health care; Health care policy; Health Care Reform; Health Personnel - organization & administration; Health Policy; Health Services Accessibility; Humans; Models, Organizational; National Health Programs - organization & administration; Ordinances; Patient Care Team - organization & administration; Primary care; Primary Health Care - organization & administration; Brazil; Brasil
• ISSN: 1413-8123; 1678-4561
• DOI: 10.1590/1413-81232018246.08802019

The Unified Health System has undergone constant evolution and expansion since the publication of Brazil's 1988 Federal Constitution. The Federal District has provided contributions to the field of Primary Health Care Policy, especially between 2016 and 2018, by defining the Family Health Strategy as the definitive way of organizing Primary Health Care (PHC) services and by establishing a set of actions aimed at conversion of existing PHC services to this model. This article describes and analyzes the key processes of this change. The method used was analysis of ordinances, resolutions, reports and other documents, as well as assessment of data from official databases. We emphasize the development of a normative structure that includes the teams' implementation, the professionals' work processes, changes in medical specialties and reorganization of the health professionals who already worked in PHC. with an effect of increasing the population's Family Health Strategy coverage (in a population of approximately 3 million inhabitants) from 28% to 69% during a two-year period, the experience demonstrates the feasibility of incremental changes in health policies such as defining priorities, better management of the workforce, training and decentralized planning to increase access to health services.