Universidade Federal da Paraíba. Departamento de Clínica e Odontologia Social. Programa de Pós-Graduação em Odontologia. João Pessoa, PB, Brasil.
Rev Saude Publica. 2021 Dec 1;55:85. doi: 10.11606/s1518-8787.2021055003005. eCollection 2021.
To analyze the effect of the 2017 Basic Primary Care Policy (PNAB) on the number of community health agents per primary health care team.
This is a cross-sectional, descriptive and analytical study using data available on the Ministry of Health platform called e-Gestor da Atenção Básica, about Brazil's 5,570 towns between October 2017 and December 2019. The survival of the number of towns that did not reduce the number of community health agents was analyzed according to region of the country, the Human Development Index (HDI), the Gini Inequality Index and population size. Cox regression was used to analyze the factors associated with a reduction in the number of CHAs after one month and, from then on, every three months until two years had passed since the publication of the 2017 PNAB Ordinance, considering p < 0.05.
After two years, the greatest reduction was observed in towns in the Midwest and South regions, which presented a high HDI, lower inequality and larger populations. Towns in the Midwest (HR = 1.256) had a higher chance of reducing the number of CHAs compared to the North region. Towns with a higher HDI (HR = 1.053) and larger population size (HR = 1.186) were also more likely to reduc the number of community health agents. Therefore, after the 2017 PNA, the number of towns reducing the amount of community health workers in primary health care increased over the months.
分析 2017 年基本初级保健政策（PNAB）对每个初级卫生保健团队中社区卫生工作者人数的影响。
这是一项使用卫生部平台上名为 e-Gestor da Atenção Básica 的可用数据进行的横断面、描述性和分析性研究，涉及 2017 年 10 月至 2019 年 12 月期间巴西的 5570 个城镇。根据国家区域、人类发展指数（HDI）、基尼不平等指数和人口规模，分析了没有减少社区卫生工作者人数的城镇数量的生存情况。使用 Cox 回归分析了在 PNAB 法令颁布后一个月内以及此后每三个月一次的因素，共分析了两年，以分析与减少 CHA 数量相关的因素，考虑到 p < 0.05。
两年后，中西部和南部地区的城镇观察到最大的减少，这些地区具有较高的 HDI、较低的不平等和较大的人口。与北部地区相比，中西部地区的城镇（HR = 1.256）减少 CHA 数量的可能性更高。具有较高 HDI（HR = 1.053）和较大人口规模（HR = 1.186）的城镇也更有可能减少社区卫生工作者的数量。因此，在 2017 年 PNA 之后，在初级卫生保健中减少社区卫生工作者人数的城镇数量逐月增加。
