Experiences of access and use of primary health care by users with systemic arterial hypertension.

Objective: To identify and analyze users' perceptions of access and use of health services and actions to monitor Systemic Arterial Hypertension (SAH) in Primary Health Care (PHC).

Methods: This is a qualitative, descriptive and exploratory study based on 38 semi-structured interviews conducted with users selected from Basic Health Units (BHUs) in a large municipality in the state of Rio de Janeiro. Thematic content analysis was used to identify the empirical categories.

[Dynamics of regionalization and repercussions of gaps in care on health marketing in remote rural municipalities].

This article analyzed the dynamics of regionalization in municipalities within hinterlands and the possible implications of gaps in care for the marketing of health. This is a multiple case study with a qualitative approach, involving 76 semi-structured interviews with municipal, regional, and state managers. The results show that, particularly in the Northern states, the regional scheme did not reflect the social dynamics of the populations and created inadequate flows and unwanted routes.

Working practices and integration of primary health care doctors in remote rural areas in Brazil: a qualitative study.

Health care challenges in remote rural municipalities (RRMs) emphasize the importance of primary health care (PHC) and require an expanded scope of practice. Doctors are key actors in this context. The aim of this study was to explore the level of integration of doctors in RRMs and working practices.

Implementation of public health consortiums and regional polyclinics in Bahia state, Brazil.

Public Health Consortiums (PHC) in Brazil represent a strategy to enhance regionalization in the Public Health Care System (SUS in Portuguese) and State/interstate/intermunicipal cooperation. The establishment of regional polyclinics aims to improve access to services with greater technological concentration and closer to users' homes. This study specifically aims to analyze the process of creating PHC and regional polyclinics in Bahia State, based on documental analysis, identifying aspects related to entering the political agenda that facilitate and hinder, the role of state administration, specificities of the composition of these PHC and regional polyclinics.

Perspectives for Primary Health Care public policy in South America.

We aim to conduct a comparative analysis of the implementation of PHC in nine South American countries. Three dimensions were highlighted from documentary sources: political commitment, leadership, and governance; care model; and engagement of communities and other stakeholders. The results indicate a formal commitment that places PHC at the center of efforts to achieve universal access.

Care trajectories of COVID-19 patients: from preventive measures to rehabilitation.

This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support.

Water, land, and air: how do residents of Brazilian remote rural territories travel to access health services?

Background: Ensuring adequate and safe means of travel is essential for maintaining and improving the health and well-being of residents of rural communities worldwide. This article maps costs, distances, travel times, and means of elective and urgent/emergency health transport in Brazilian remote rural municipalities.

Methods: Multiple case studies were conducted in 27 remote rural municipalities using a qualitative method.

Challenges to the provision of specialized care in remote rural municipalities in Brazil.

This case study analyses the challenges to providing specialized care in Brazilian remote rural municipalities (RRM). Interviews were conducted with managers from two Brazilian states (Piauí and Bahia). We identified that the distance between municipalities is a limiting factor for access and that significant care gaps contribute to different organizational arrangements for providing and accessing specialized care.

[Interfederative Health Consortium in the State of Bahia, Brazil: implementation, management mechanism, and sustainability of the organizational arrangement in the Brazilian Unified National Health System].

Analysis of the implementation, management, operation and sustainability of the Interfederative Health Consortia and the Regional Specialty Polyclinics, in the State of Bahia, Brazil. This is a single case study of a qualitative nature, with interviews with managers, social control, regulation, legislative, and mayors of municipalities in the member. The results indicate that capital expenditures and permanent cofinancing by the state manager are factors that encourage the participation of vertical consortia.

Specialized care and health transport from a Health Care Network integration perspective.

The aim of this study was to analyze the organization and provision of specialized care (SC) and health transport in regional polyclinics in the state of Bahia, Brazil. We conducted a qualitative exploratory single case study of a polyclinic based on semi-structured interviews with key informants in municipal and state health services. We sought to identify elements that characterize network-based models of SC.

Different remote realities: health and the use of territory in Brazilian rural municipalities.

Objective: To characterize remote rural Brazilian municipalities according to their logic of insertion into socio-spatial dynamics, discussing the implications of these characteristics for health policies.

Methods: Starting from the category of analysis - the use of the territory - a typology was elaborated, with the delimitation of six clusters. The clusters were compared using socioeconomic data and the distance in minutes to the metropolis, regional capital, and sub-regional center.

[Evaluation of cervical cancer control actions within Brazil and its regions based on data recorded in the Brazilian Unified National Health System].

This study analyzes the performance of screening and diagnosis tests for cervical cancer among women aged 25 to 64 years, as well as the delay for the initiation of treatment within Brazil and in its geographic regions, from 2013 to 2020. Information on populational procedures and estimates was obtained from the information systems of the Brazilian Unified National Health System and the Brazilian National Supplementary Health Agency. We calculated the coverage indicators of the Pap smear, the percentages of altered cytopathological and histopathological tests, and the percentage of women diagnosed with cervical cancer with over 60 days of treatment.

Context and organization of primary health care in remote rural communities in Northern Minas Gerais State, Brazil.

The study analyzes the structural characteristics of primary health care (PHC) in its contextual and organizational dimensions in remote rural municipalities (counties) in Northern Minas Gerais State, Brazil. This is a case study with a qualitative approach, using 21 semi-structured interviews with health system administrators and health care workers from the family health teams (EqSF), as well as secondary data. For the contextual dimension, the results show that socioeconomic factors in the remote rural municipalities condition the organization of PHC and leave the population vulnerable, especially in the rural areas of the remote municipalities.

Provision of specialized care in remote rural municipalities of the Brazilian semi-arid region.

Introduction: Specialized care barriers are widespread and multifactorial, with consequences for timely access, health outcomes, and equity, especially in rural contexts. This article aims to identify and analyze arrangements for providing specialized care in the Brazilian remote rural municipalities (RRMs).

Methods: This is a multiple-case qualitative case study developed in seven RRMs located in the Brazilian semi-arid region.

Public-private relations in Chile's health system: regulation, funding and service delivery.

This article analyzes the configuration of public-private relations in Chile's health system between 2000 and 2018, focusing on organization and regulation, funding and service delivery. The following data collection methods were employed: literature review, content analysis of official documents and secondary data, and semi-structured interviews. With regard to organization and regulation, the findings show a lack of institutional mechanisms to mitigate risk selection and that access to private services is intimately linked to ability to pay.

Cervical cancer guidelines, prevention and screening strategies: experiences from Brazil and Chile.

This article analyzes cervical cancer control policies and actions in Brazil and Chile, focusing on prevention and screening. We adopted a comparative approach to identify similarities and differences in guidelines and cervical cancer prevention and screening strategies between the two countries. We used the following data collection techniques: analysis of official documents and secondary data, consultations with experts, government officials and program coordinators, and literature review.

[The work process for community health agents: contributions to care in remote rural territories in Amazonia, Brazil].

The article aims to analyze the work process for community health agents (ACS in Portuguese) in remote rural municipalities (counties) and identify specificities and contributions to primary healthcare. The qualitative study included 23 interviews with ACS and nurses in the family health teams in five remote rural counties in western Pará State, Brazil. Analysis of the work process for ACS covered two interconnected dimensions: scope of practices and qualification for the work.

Informal and popular healthcare subsystems in a remote rural municipality in the Brazilian Amazon region.

Introduction: While Brazil has achieved a significantly higher coverage through primary care and improved health outcomes through the Family Health Strategy, rural areas still have worse indicators and several barriers to access primary healthcare units, which sometimes condition users to seek alternative answers outside the formal circuit. From the framework of medical anthropology, Arthur Kleinman indicates that the sociohistorical-cultural context also determines the search for health care, and not only by the conditions of access and availability of formal services. From this perspective, each health system would consist of three interrelated subsystems: the informal, the popular, and the professional subsystem, widely used in an overlapping and non-exclusive way, interacting according to an individual's needs.

Quality of Actions to Control Cervical Cancer in Bahia, Brazil.

Objective: To assess the quality of the actions to control cervical cancer (CC) and its correlates.

Methods: This is a cross-sectional study conducted from January to March 2019 in 19 municipalities in Bahia, Brazil, with a sample of 241 doctors and nurses from primary health care (PHC). Three dependent variables were chosen- "Performance of educational, promotion, prevention, and monitoring actions" (D1); "Access to diagnostic tests" (D2); "Non-occurrence of high grade cervical squamous intraepithelial lesions (HSIL)" (D3).

The Family Health Strategy coverage in Brazil: what reveal the 2013 and 2019 National Health Surveys.

This paper examines the evolution of Brazil's Family Health Strategy coverage from the findings of the 2013 and 2019 National Health Survey censuses. Indicators included Family Health Clinic coverage of residents and households, frequency of visits by Community Health Workers, and usual source of care, all stratified by rural and urban areas, Brazilian regions, states, education of the household head, and income quintile. In 2019, 60.

Experience with coordination of care between primary care physicians and specialists and related factors.

The article analyzes the coordination of information and clinical management between levels of care in physicians' experience and explores related labor and organizational factors and attitudes towards the work and interaction. This is a cross-sectional study with application of the COORDENA-BR questionnaire to a sample of 64 primary health care (PHC) physicians and 56 specialized care (SC) from the public system in a medium-sized Brazilian city. The results show limited linkage of care in the Healthcare Network (RAS), with differences between PHC and SC.

Primary health care in the 25 years of Journal Ciência & Saúde Coletiva.

Primary Health Care (PHC) is an area of study that has improved remarkably in the last decades. In Brazil, this academic production is highly expressed in the field of Collective Health. This paper aims to analyze the PHC production published in the first 25 years of the "Journal Ciência & Saúde Coletiva" (C&SC).

Health policies in Chile (2000-2018): trajectory and conditioning factors.

In the 1980s, during the military dictatorship, Chile was a forerunner in Latin America in radical health system reform, expanding the private sector's participation in health insurance and services provision and influencing reforms in other countries of the region. The article analyzes health policies in Chile from 2000 to 2018, in the context of four democratic government administrations, considering continuities and changes in the policies' development and their conditioning factors. The analytical reference drew on contributions from historical institutionalism.