Quality of Primary Health Care in Brazil: advances, challenges and perspectives

Abstract

The essay brings together advances, problems and proposals on the quality of Primary Health Care in  Brazil, emphasizing the comprehensiveness of care,  expressed in the completeness of health actions.  Studies on access and quality of the Family Health  Strategy (FHS) highlight advances in the expansion of  population coverage and access of health actions, in  the improvement of the structure of services, and  provision of doctors. Structural problems persist, with  emphasis on the availability of essential inputs and  information and communication technologies. The  organization and management of the services and of  the professional practice of the teams suffer from a  systemic problem of incompleteness of the offer of  actions and health care, despite the references  standards, guidelines, goals and protocols. We  propose the universalization of FHS in Brazil with  guarantees of investments in the structure of the services, complete team with doctors, nurses, dentists, nursing technicians and Community Health Agents  with full dedication. Programs of continuous  education, institutionalization of monitoring and  evaluation practices in local teams and the  accomplishment of ‘quality collective efforts’  stimulate the systemic improvement of the FHS in  Brazil, contributing to the reduction of health  inequalities.