[Show abstract][Hide abstract] ABSTRACT: Expansion of the Family Health Program in Brazil requires indicators to evaluate the consistency of the approach actually adopted and the program's underlying principles. Together with the family health chart, the family health history (medical genealogy) allows improved follow-up of the clientele's health and the quality of care provided. This study used the family health chart based on external evaluation (accreditation) of family health teams and managers. The results showed variation in the health charts' conformity to the accreditation standard according to the nature of the function evaluated. The study showed the importance of external evaluation to signal the level of conformity to the required standards, suggesting the need to operate with a combined indicator, including internal and external evaluation of family health data as a management instrument.
[Show abstract][Hide abstract] ABSTRACT: The 1988 Federal Constitution incorporated the broader concept of health, which, from the legal viewpoint, is the possibility of legitimating health as everyone's right and the State's duty. However, when this civil health right enters the Brazilian scenario, it is hard to imagine the whole society as an equal set of individual and collective demands before the outrageous social inequality even when people share the same geographical area. In this context, and based on the Family Health Strategy (FHS), formulated by the Ministry of Health in 1994, established as priority in the political Brazilian scenario, this study aims to identify the limits and possibilities of this proposal to guarantee health rights for the Brazilian population as a whole, and particularly, Rio de Janeiro's inhabitants. It is a descriptive research with a qualitative approach that uses bibliographic and documentary research, besides the semistructured interview carried out with two FHS actors in the state and municipal spheres of Rio de Janeiro. As a result, it was possible to identify that nowadays, almost 20 years after the Constituent Assembly, and 12 years after the implementation of the Family Health Strategy, the latter still represents only a possibility to make the principles of the Unified Health System real, hence ensuring health as everyone's right.
Physis Revista de Saúde Coletiva 12/2007; 18(1):27-44.
[Show abstract][Hide abstract] ABSTRACT: As part of the baseline studies of the PROESF (Project for the Expansion and Consoli- dation of Family Health), this article studies the funding of the PSF (Program for Family Health) from the viewpoint of its financial sustainability. It approaches aspects related to the construction of measures and indicators for sustainability based on a recent Brazilian political experience of differentiating the financial incentives given by the Unified Health System (SUS) through the PROESF to municipalities with more than 100 thousand inhabitants. The suggested inclusion of indicators only allows for defining the long-term coherence of the planned actions from the finan- cial standpoint. This approach does not exclude the need for a critical review of the criteria cur- rently used by the incentive policy of the PSF and its differentiation between municipalities, which is not exclusively based on their size. The differ- ences in the situations of the municipalities with respect to sustainability pointed out in this study draw attention to the limits and limitations of applying alike policies to unalike situations, with foreseeable consequences of maintaining or wors- ening inequity.