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Reform movements in the Federal District Health Care System:conversion of the Primary Health Care assistance model.

Daniel Seabra Resende Castro CorrêaAlexandra Gouveia de Oliveira Miranda MouraMarcus Vinícius QuitoHeloiza Machado de SouzaLuciana Martins VersianiSérgio LeuzziLeila Bernarda Donato GöttemsJames Macinko
Published in: Ciencia & saude coletiva (2019)
The Unified Health System has undergone constant evolution and expansion since the publication of Brazil's 1988 Federal Constitution. The Federal District has provided contributions to the field of Primary Health Care Policy, especially between 2016 and 2018, by defining the Family Health Strategy as the definitive way of organizing Primary Health Care (PHC) services and by establishing a set of actions aimed at conversion of existing PHC services to this model. This article describes and analyzes the key processes of this change. The method used was analysis of ordinances, resolutions, reports and other documents, as well as assessment of data from official databases. We emphasize the development of a normative structure that includes the teams' implementation, the professionals' work processes, changes in medical specialties and reorganization of the health professionals who already worked in PHC. with an effect of increasing the population's Family Health Strategy coverage (in a population of approximately 3 million inhabitants) from 28% to 69% during a two-year period, the experience demonstrates the feasibility of incremental changes in health policies such as defining priorities, better management of the workforce, training and decentralized planning to increase access to health services.
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