Primary healthcare: a multidimensional study on challenges and potential in the São Paulo Metropolitan Region (SP, Brazil)

• Published in: Ciência & saude coletiva Vol. 16; no. 6; pp. 2877 - 2887
• Main Authors: Heimann, Luiza Sterman, Ibanhes, Lauro Cesar, Boaretto, Roberta Cristina, Castro, Iracema Ester do Nascimento, Telesi Júnior, Emilio, Cortizo, Carlos Tato, Fausto, Márcia Cristina Rodrigues, do Nascimento, Vânia Barbosa, Kayano, Jorge
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01-06-2011
• Subjects: Brazil; Humans; Primary Health Care - economics; Primary Health Care - organization & administration; Urban Health; Brazil
• ISSN: 1678-4561
• DOI: 10.1590/S1413-81232011000600025

This paper presents some results of a case study in the Metropolitan Region of São Paulo (SP, Brazil) as part of a multicentric study conducted in Argentina, Brazil, Paraguay and Uruguay. The aim is to evaluate Primary Health Care (PHC) as a strategy to achieve integrated and universal healthcare systems. The methodological approach was based on five analytical dimensions: stewardship capability; financing; provision; comprehensiveness and intersectoral approach. The techniques included literature review, document analysis and interviews with key informants: policy makers; managers, experts, users and professionals. The results were organized in response to the challenges and possibilities of PHC as a structural system according to the five dimensions. The following emerged from the interviews: different interpretations on the concept and role of PHC and a consensus as the gateway to the system; weaknesses in funding; challenges in health workforce administration and the need for new legal-institutional design for regional management. The potential aspects were: broader coverage/universality, PHC as the basis for the organization of the system; connection with the territory and understanding specific population needs.