Primary Health Care Infrastructure Regarding Tuberculosis Control: A Countrywide Cross-sectional Study | 64397
Primary Healthcare: Open Access
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Statement of the Problem: The Brazilian awareness and investments to the control of tuberculosis (TB) are associated with subjects
like infectious diseases control programs, health promotion and construction of public policies regarding primary health assistance by
means of the Unified Health System (Portuguese Acronym is SUS). Somehow, Primary Health Care (PHC) contains the infrastructural
and professional resources to carry out diagnosis and treatment of TB. Primary health care has good operational indicators regarding
the control and management of TB in Brazil.
Aim: The purpose of this study was to analyze physical infrastructure resources of primary health care centers at SUS regarding the
control of TB in Brazil.
Methodology & Theoretical Orientation: It is a cross-sectional study based on data collected from 38812 primary health care centers
in all Brazilian territory. All the health centers were visited by a group of researchers between 2011-2013. The researchers developed
interviews with the health centers managers and checked for all infrastructure resources. Dependent variable were described by
the presence and availability of the following infrastructure items: nursing consultation; vaccination facility room; air circulation;
refrigerator; individual protective equipment; plastic jar to sputum; tuberculosis notification form and BCG-ID vaccine. The covariables
were related to: type of primary health center, week days of attendance, shifts of attendance, indoor services signaling and
nursing consultation room with privacy. Poisson regression with robust variance was used to calculate prevalence ratio, with intervals
of confidence of 95%.
Results: Of 38812 primary health care centers evaluated, only 1628 (4.18%) presented a positive result in all assessed infrastructure
items, which drew up the study outcome. Among all types of centers, Primary Health Centers were associated with the highest quality
in infrastructure for tuberculosis, in all Brazilian macro regions. The centers with larger shifts of attendance, as well as those that
presented a list of offered services and nursing consulting room, also presented highest quality.
Conclusions: The present study points that improvements should be done regarding infrastructure resources to reach a satisfactory
tuberculosis control nationwide. Public health policies should support these improvements to infectious diseases control within
primary health care in Brazil.
Alexandre Favero Bulgarelli has his expertise in evaluation and assessment of Primary Health Services in development of Public Health Systems. Currently, he is a Public Health Professor at Federal University of Rio Grande do Sul, Brazil. 3