偏远农村城市的初级卫生保健:巴西国家卫生系统的背景、组织和获得综合保健

IF 0.5 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Saude E Sociedade Pub Date : 2023-01-01 DOI:10.1590/s0104-12902023220382en
M. Fausto, P. F. D. Almeida, A. Bousquat, J. Lima, Adriano Maia dos Santos, Helena Seidl, M. H. Mendonça, L. Cabral, L. Giovanella
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引用次数: 1

摘要

尽管存在社会空间多样性,但偏远的农村地区普遍存在分散在广阔领土上的小村庄,人口孤立,距离城市中心很远。该研究的目的是分析巴西国家卫生系统(SUS)在偏远农村城市(MRR)的组织和获得初级卫生保健(PHC)的特殊性。为此目的,开展了一项基于27个MRR的多案例研究的定性方法研究。对211次对管理人员和卫生专业人员的半结构化访谈进行了主题内容分析,并对信息进行了三角测量,以探索和认识保健服务的组织形式、战略和挑战。结果表明:偏远农村环境的特点决定了初级卫生保健的提供;在提供保健行动的方式上存在差异,在城市最偏远地区的保健覆盖面方面存在较大差距;国家初级保健经费与人口稀少、路途遥远的地区特点之间存在矛盾;劳动力短缺是研究城市面临的共同挑战。因此,有必要考虑到卫生服务的地域、社会和获取特点,以提出符合MRR需求的公共政策。
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Primary Health Care in remote rural municipalities: context, organization, and access to integral care in the Brazilian National Health System
Abstract Despite the socio-spatial diversity, remote rural locations have in common small villages dispersed over a vast territory, isolated populations, and long distances from urban centers. The objective of the study is to analyze the specificities of the organization and access to primary health care (PHC) in the Brazilian National Health System (SUS) in remote rural municipalities (MRR). To that end a study with a qualitative approach, based on a multiple case study in 27 MRR was carried out. Thematic content analysis of 211 semi-structured interviews with managers and health professionals and a triangulation of information to explore and recognize the forms of organization, strategies, and challenges for the access to health were performed. The results indicate that: the characteristics of remote rural contexts condition the provision of PHC; there are differences in the ways of offering health actions and greater gaps in care coverage in the most rarefied and remote areas of the municipalities; there are contradictions between national PHC funding and the characteristics of territories marked by sparcely populated areas and long distances; and the shortage of the workforce is a common challenge among the cities studied. It is, thus, necessary to consider the territorial, social, and access characteristics to health services to propose public policies that meet the needs of the MRR.
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来源期刊
Saude E Sociedade
Saude E Sociedade PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
0.90
自引率
16.70%
发文量
45
审稿时长
12 weeks
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