Inequalities in the work process of Brazilian primary health care teams: a rural-urban analysis based on PMAQ-AB data

 

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Autori: Lemos , Messias, Figueiredo Cunha , Carlos Leonardo, Costa Pinheiro , Helder Henrique, Castelo Branco de Oliveira Bastos , Maria do Socorro, Bandeira de Sá , Naiza Nayla, Cordeiro Pereira, Átila Augusto, Oliveira Naiff Ferreira , Glenda Roberta, Guedes dos Santos , José Luís, Garcia Lourenção , Luciano
Natura: artículo original
Status:Versión publicada
Data di pubblicazione:2025
Descrizione:Objective: To evaluate the work process of Primary Health Care teams in Brazil, based on the rural/urban typology defined by the Brazilian Institute of Geography and Statistics. Method: This is a cross-sectional evaluative study with a quantitative and analytical approach, based on secondary data from the third cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB), conducted between 2017 and 2018. A total of 37,350 Primary Health Care (PHC) teams (96.1% of those approved for participation) were analyzed. The study focused on two analytical axes: (1) territorialization and (2) team planning. Data were processed using Multiple Correspondence Analysis (MCA), which enabled the identification of patterns in the organization of work processes based on municipal typology. Results: The study revealed important disparities across municipal strata. Adjacent rural municipalities had the lowest percentage of teams with uncovered populations (21.0%), while urban and remote intermediate municipalities showed the highest rates (42.0% and 43.6%, respectively). Regarding planning, 15.1% of teams reported not conducting planning activities, with the lowest proportions found in remote municipalities. The MCA perceptual maps identified three main clusters, showing the concentration of positive organizational attributes in intermediate adjacent municipalities and weaker work processes in remote areas. Conclusion: The organization of PHC teams' work processes varies significantly according to the rural/urban classification of municipalities. These findings reinforce the need for territorialized policies and differentiated support strategies to strengthen PHC performance in diverse Brazilian contexts.
Stato:Portal de Revistas UCR
Istituzione:Universidad de Costa Rica
Repositorio:Portal de Revistas UCR
Lingua:Inglés
OAI Identifier:oai:portal.revistas.ucr.ac.cr:article/735
Accesso online:https://revistas.ucr.ac.cr/index.php/rpsm/article/view/735
Keyword:Primary Health Care
Public Health
Community Health Planning
Health Care Process Assessmen
Rural Health Services
Atención Primaria de Salud
Salud Pública
Planificación en Salud Comunitaria
Evaluación de Procesos en Salud
Servicios de Salud Rural