title: [Primary healthcare: a multidimensional study on challenges and potential in the São Paulo Metropolitan Region (SP, Brazil)].
abstract: This paper presents some results of a case study in the Metropolitan Region of São Paulo (SP, Brazil) as part of a multicentric study conducted in Argentina, Brazil, Paraguay and Uruguay. The aim is to evaluate Primary Health Care (PHC) as a strategy to achieve integrated and universal healthcare systems. The methodological approach was based on five analytical dimensions: stewardship capability; financing; provision; comprehensiveness and intersectoral approach. The techniques included literature review, document analysis and interviews with key informants: policy makers; managers, experts, users and professionals. The results were organized in response to the challenges and possibilities of PHC as a structural system according to the five dimensions. The following emerged from the interviews: different interpretations on the concept and role of PHC and a consensus as the gateway to the system; weaknesses in funding; challenges in health workforce administration and the need for new legal-institutional design for regional management. The potential aspects were: broader coverage/universality, PHC as the basis for the organization of the system; connection with the territory and understanding specific population needs.
authors.affiliation: Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo, São Paulo 01314-000.
authors.forename: Luiza Sterman
authors.initials: LS
authors.lastname: Heimann
authors.forename: Lauro Cesar
authors.initials: LC
authors.lastname: Ibanhes
authors.forename: Roberta Cristina
authors.initials: RC
authors.lastname: Boaretto
authors.forename: Iracema Ester do Nascimento
authors.initials: IE
authors.lastname: Castro
authors.forename: Emilio
authors.initials: E
authors.lastname: Telesi Júnior
authors.forename: Carlos Tato
authors.initials: CT
authors.lastname: Cortizo
authors.forename: Márcia Cristina Rodrigues
authors.initials: MC
authors.lastname: Fausto
authors.forename: Vânia Barbosa
authors.initials: VB
authors.lastname: do Nascimento
authors.forename: Jorge
authors.initials: J
authors.lastname: Kayano
mesh_terms: D001938:Brazil; D006801:Humans; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration; D014504:Urban Health