Ciência & Saúde Coletiva
On-line version ISSN 1678-4561Print version ISSN 1413-8123
HEIMANN, Luiza Sterman et al. Primary healthcare: a multidimensional study on challenges and potential in the São Paulo Metropolitan Region (SP, Brazil). Ciênc. saúde coletiva [online]. 2011, vol.16, n.6, pp.2877-2887. ISSN 1678-4561. http://dx.doi.org/10.1590/S1413-81232011000600025.
This paper presents some results of a case study in the Metropolitan Region of São Paulo (SP, Brazil) as part of a multicentric study conducted in Argentina, Brazil, Paraguay and Uruguay. The aim is to evaluate Primary Health Care (PHC) as a strategy to achieve integrated and universal healthcare systems. The methodological approach was based on five analytical dimensions: stewardship capability; financing; provision; comprehensiveness and intersectoral approach. The techniques included literature review, document analysis and interviews with key informants: policy makers; managers, experts, users and professionals. The results were organized in response to the challenges and possibilities of PHC as a structural system according to the five dimensions. The following emerged from the interviews: different interpretations on the concept and role of PHC and a consensus as the gateway to the system; weaknesses in funding; challenges in health workforce administration and the need for new legal-institutional design for regional management. The potential aspects were: broader coverage/universality, PHC as the basis for the organization of the system; connection with the territory and understanding specific population needs.
Keywords : Primary Health Care; Brazilian Health System; Metropolitan region.