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[从用户和卫生专业人员的角度看巴西里约热内卢州初级保健重新定位中的健康实践]

[Health practices in the reorientation of primary care in Rio de Janeiro State, Brazil, from the perspective of users and health professionals].

作者信息

Tavares Maria de Fátima Lobato, Mendonça Maria Helena Magalhães de, Rocha Rosa Maria de

机构信息

Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Publica Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2009 May;25(5):1054-62. doi: 10.1590/s0102-311x2009000500012.

Abstract

This evaluative study focused on expansion of the Family Health Strategy in large cities in Rio de Janeiro State, Brazil. The study analyzed the functionality of health care modalities, performance, and supply of comprehensive care itself and its link to services at other levels. The thrust of the analysis was comprehensiveness of care in the daily routine of health services, with a focus on childbearing-age women, and with pregnancy as the tracer condition. The results emerged from an analysis of focus groups with health care users and health professionals, based on: characterization of key actors; their perceptions concerning health, healthcare model, and organization of primary care services and practices. The groups suggested that the actors perceive health as identified with social determinants. Access to services and actions was differentiated in the family health unit by enrollment of the clientele and active search, and the study showed the lack of a structured network. The study indicates that work processes contemplating the social determination of health and its intersectorality can lead to expanded access to comprehensive care for childbearing-age women.

摘要

这项评估研究聚焦于巴西里约热内卢州大城市家庭健康战略的扩展。该研究分析了医疗保健模式的功能、绩效以及综合护理本身的提供情况及其与其他层面服务的联系。分析的重点是卫生服务日常工作中的护理全面性,以育龄妇女为重点,并以怀孕作为追踪情况。研究结果来自对医疗保健使用者和卫生专业人员焦点小组的分析,基于:关键行为者的特征;他们对健康、医疗保健模式以及初级保健服务和实践组织的看法。这些小组表明,行为者将健康视为与社会决定因素相关。通过客户登记和积极寻找,家庭健康单位在获得服务和行动方面存在差异,并且研究表明缺乏结构化网络。该研究表明,考虑到健康的社会决定因素及其部门间性的工作流程可以扩大育龄妇女获得综合护理的机会。

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