Ramos Luiz Roberto, Malta Deborah Carvalho, Gomes Grace Angélica de Oliveira, Bracco Mário M, Florindo Alex Antonio, Mielke Gregore Iven, Parra Diana C, Lobelo Felipe, Simoes Eduardo J, Hallal Pedro Curi
Rev Saude Publica. 2014 Oct;48(5):837-44. doi: 10.1590/s0034-8910.2014048005249.
Assessment of prevalence of health promotion programs in primary health care units within Brazil's health system.
We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units.
Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did.
Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.
评估巴西卫生系统内初级卫生保健单位中健康促进项目的普及情况。
我们基于对初级保健单位管理人员的电话访谈开展了一项横断面描述性研究。在巴西统一卫生系统目录中列出的总共42486个初级卫生保健单位中,随机选取了1600个。按各地区单位数量比例从巴西所有五个大区中选取保健单位。我们调查了是否有以下五种不同类型的健康促进项目:体育活动;戒烟;戒酒和戒毒;健康饮食;以及健康环境。收集了各单位提供的活动种类以及家庭健康战略的实施状况信息。
大多数单位(62.0%)报告有三种或更多健康促进项目,只有3.0%的单位报告没有。健康环境项目(77.0%)和健康饮食项目(72.0%)最为普及;54.0%的单位报告有戒烟项目,42.0%的单位报告有戒酒项目。不到40.0%的单位提供体育活动项目,其普及程度在全国差异很大,从东南部的51.0%到北部低至21.0%。大多数单位(61.0%)实施了家庭健康战略;然而,它们提供的健康促进项目并不比其他单位多。
我们的研究表明,大多数初级保健单位都有健康促进项目。需要制定公共政策来加强初级保健服务,并改善卫生服务提供者的培训,以实现巴西健康促进议程的目标。