[Challenges in primary health care: the experience in Vila Mariana District, São Paulo, Brazil].
This article presents the results of a case study aimed at identifying challenges for the delivery of primary health care in a health district in the city of São Paulo, Brazil, considering comprehensiveness as a central device for organizing work at this level of care. Five units in the district's primary care network were studied. We collected the data by observing work routines and flows, conducting interviews with managers and health professionals from different backgrounds, and through focus groups with family health teams. The analysis shows a mismatch between users' characteristics and their presumed needs and the heterogeneity of the health professionals' perceptions concerning their work. Lack of staff and time and difficulties with referrals were the main problems identified by interviewees.
Villela
Wilza Vieira
WV
Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, Brasil. wilsa.vieira@terra.com.br
Araújo
Eliane Cardoso de
EC
Ribeiro
Sandra Aparecida
SA
Cuginotti
Aloísio Punhagui
AP
Hayana
Eliana Tiemi
ET
Brito
Francisco Carlos de
FC
Ramos
Luiz Roberto
LR
D001291:Attitude of Health Personnel; D001938:Brazil; D003695:Delivery of Health Care / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006298:Health Services Administration; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D019982:Organizational Case Studies; D011320:Primary Health Care / Q000458:organization & administration*