Silva Amanda Marinho da, Fausto Márcia Cristina Rodrigues, Gonçalves Maria Jacirema Ferreira
Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Brasil.
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2023 Feb 6;39(1):e00163722. doi: 10.1590/0102-311XPT163722. eCollection 2023.
This single-case study aimed to evaluate access the geographic accessibility and availability of primary health care (PHC) in a remote rural municipality in Amazonas Stater, Brazil, to control systemic arterial hypertension. A thematic analysis was conducted to interpret the content of 11 semi-structured interviews with municipal managers, PHC professionals, and hypertensive healthcare users. Geographical accessibility is associated with river mobility, transportation availability, users' financial travelling condition, and the presence of services near riverine communities, whereas availability to diagnose and monitor hypertensive patients depend on the presence of healthcare providers, medications, and equipment and the integration of PHC with the local health care network. Although access to health is more complex than our research goals, the evaluated dimensions show weaknesses which are exacerbated by a context marked by socio-spatial disparities and absent public policies, compromising the guarantee of individuals' right to health.
本单案例研究旨在评估巴西亚马孙州一个偏远农村市镇的初级卫生保健(PHC)在地理可达性和可用性方面的情况,以控制系统性动脉高血压。对与市镇管理人员、初级卫生保健专业人员和高血压患者进行的11次半结构化访谈的内容进行了主题分析。地理可达性与河流交通、交通便利性、用户的财务出行状况以及河边社区附近服务的存在有关,而诊断和监测高血压患者的可用性则取决于医疗服务提供者、药物和设备的存在以及初级卫生保健与当地卫生保健网络的整合。尽管获得医疗服务比我们的研究目标更为复杂,但所评估的维度显示出弱点,而社会空间差异和缺乏公共政策的背景加剧了这些弱点,损害了个人健康权的保障。