Primary health care in leprosy, assessed by users and professionals

N. A. Barboza, Viriato Campleo, A. A. Lustosa, B. Sampaio, G. Araújo
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Abstract

Objective: Evaluate the performance of primary health care in control of leprosy in Teresina, Brazil from the perspective of users and professionals. Methods: This cross-sectional, descriptive study involved 25 healthcare users with leprosy and 34 professionals (physicians and nurses) working in 13 municipal health units within the urban area of Teresina. The data were collected from January to June, 2017, using the Instrument for Assessing the Performance of Primary Care in Leprosy Control Actions, a document based on the Primary Care Assessment Tool/PCATool Brasil which measures the presence and extension of essential and derived attributes from primary health care. Results: The mean scores obtained for the essential, derived and global attributes, through the perception of the users, were lower than 6.6, indicating that the primary health services in Teresina are not sufficiently oriented to carry out leprosy control actions, mainly in terms of access, integrality of services provided, family orientation and community orientation. The professionals showed a contrasting view, with averages exceeding 6.6 for all attributes and scores. The difference in perception between the groups was significant for all attributes except for coordination (Mann-Whitney U test, p = 0.479).The overall evaluation of quality was not influenced by the user’s clinical or socioeconomic variables, but  rather by the organization/provision of services. Conclusions: The municipal health units within the urban area of Teresina must be strongly guided by primary health care attributes in order to reach higher levels of user satisfaction.
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由使用者和专业人员评估的麻风病初级卫生保健
目的:从使用者和专业人员的角度评估巴西Teresina初级卫生保健在控制麻风病方面的表现。方法:这项横断面描述性研究涉及25名麻风病患者和34名专业人员(医生和护士),他们在Teresina市区的13个市级卫生单位工作。数据收集于2017年1月至6月,使用《评估麻风病控制行动中初级保健表现的工具》,这是一份基于初级保健评估工具/PCATool Brasil的文件,用于衡量初级保健的基本属性和衍生属性的存在和扩展。结果:通过用户的感知,基本属性、派生属性和全局属性的平均得分均低于6.6,表明Teresina的初级卫生服务在开展麻风病控制行动方面没有足够的导向性,主要是在获得服务、提供服务的完整性、家庭导向和社区导向方面。专业人士表现出了截然不同的观点,所有属性和分数的平均值都超过了6.6。除协调外,各组之间的感知差异在所有属性上都很显著(Mann-Whitney U检验,p=0.479)。质量的总体评估不受用户的临床或社会经济变量的影响,而是受服务的组织/提供的影响。结论:Teresina市区内的市级卫生单位必须以初级卫生保健属性为导向,才能达到更高水平的用户满意度。
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