Utilidade da avaliação da atenção primária à saúde: Um estudo de caso no Brasil

Abstract

Introduction: Many countries will feel the need to endorse sectors that are the responsibility of the State, fundamentally one of them for the health system. Objective: To assess the planning, conduct and execution of the PMAQ External Evaluation based on internationally recognized profit standards. Methodological path: this is an excerpt from the national meta evaluation research that is part of the project "Evaluation of the External Evaluation of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in Brazil: A Case Study". The research has a qualitative approach, with triangulation of pigtail techniques. A documentary analysis (two selected criteria, two utility standards) of 16 documents, seven semi-structured interviews and seven focus groups with coordinators and an evaluation team from the Ministry of Health and Research Institutions (IEP) was carried out. The pigtail instruments were validated by the Delphi technique by 16 specialists and a pilot study. These data were collected by a team of 11 researchers from June 2018 to March 2019, with representatives from the Ministry of Health and 6 Teaching and Research Institutions. To analyze two data, use the Atlas software and thematic content analysis. Results: Stakeholders are not involved in carrying out the External Assessment (EA) process in a systematic and participatory manner. It is noteworthy, that is, the highlight of the IEPs not conducting the process and implementing the evaluation process. Another important factor was the role of two diseases in the collaboration and involvement of AE, confirming their role in Primary Health Care (PHC). However, there are two users of the incipient participation of responses and interventions. The credibility of two evaluators was consolidated through IEPs, which they estimate to stand out for having carried out large-scale evaluations successfully in the Brazilian PHC, as well as for all the theoretical background necessary to carry out the AE. The interviewers (professionals trained preferably in the health area) are selected in their regions, which will provide credibility, not an evaluation process and will facilitate the conduct and communication of the EA. Conclusion: The results obtained in the EA were conducted, processed and interpreted by the various actors involved and will serve as a parameter to indicate which are the most weaknesses and potentials, regional and national, of the two PHC health services in Brazil. In the meantime, there was a dichotomy among stakeholders in the dissemination of results, clearly demonstrating the gaps that exist in PHC and the impact that these rendered would have on the necessary services.