title: Primary Health Care Reform in the cities of Lisbon and Rio de Janeiro: context, strategies, results, learning and challenges.
abstract: On the 30th anniversary of Alma-Ata, the World Health Organization published in 2008 the "Primary Health Care Now More Than Ever" Report, calling on all governments to reflect on the need to reflect on four sets of reforms. These included: (i) universal coverage reforms; (ii) service delivery reforms; (iii) public policies reforms that would ensure healthier communities; and (iv) leadership reforms. In this context, in the period 2005-2016, the cities of Rio de Janeiro and Lisbon developed a profound primary healthcare reform, and did so by sharing many of the solutions based on the best internationally recognized organizational practices. Several factors were fundamental throughout Lisbon and Rio de Janeiro's path of reforms, namely: (i) teamwork with professional motivation; (ii) internal and external communication; (iii) strengthening of training activities; (iv) investment in facilities and equipment; (v) commitment to the information system and computerization; (vi) pay-for-performance; (vii) health care contractualisation between funders and providers; (viii) technical leadership; (ix) political leadership; and finally (x) quality and accreditation of facilities by public agency.
authors.affiliation: Sistema Único de Saúde (SUS), Secretaria Municipal de Saúde da Cidade do Rio de Janeiro. R. Afonso Cavalcanti 455/701, Cidade Nova. 20211-110 Rio de Janeiro RJ Brasil. danielsoranz@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Soranz
authors.affiliation: Conselho Diretivo da Administração Regional de Saúde de Lisboa e Vale do Tejo, Serviço Nacional de Saúde. Lisboa Portugal.
authors.forename: Luís Augusto Coelho
authors.initials: LA
authors.lastname: Pisco
mesh_terms: D001938:Brazil; D002947:Cities; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D018166:Health Care Reform; D006801:Humans; D038622:Internationality; D007857:Leadership; D011174:Portugal; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D011634:Public Health; D011640:Public Policy