Date Published: April 18, 2019
Publisher: Public Library of Science
Author(s): Tatiana Pereira Santos, Antônio Thomaz Gonzaga Matta Machado, Mauro Henrique Nogueira Guimarães Abreu, Renata Castro Martins, M Barton Laws.
This cross-sectional study evaluated the management and organisation of primary dental care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care (PMAQ-AB) were used. Dentists from 18,114 Oral Health Teams (OHTs) answered a structured questionnaire in 2014. The data were analyzed descriptively and by cluster analysis. Half the Brazilian OHTs (51.0%) undertake planning and programming of activities. The majority of OHTs (66.4%) conducted monitoring and analysis of indicators and oral health information. The majority of OHTs had performed some self-evaluation process in the last 6 months (67.5%) and utilised self-evaluation results for planning and programming actions (71.4%). The OHTs grouped in Cluster 1 demonstrated better management organisation, followed by the teams grouped in Cluster 2. In the Brazilian macro-regions, the more OHTs were grouped in Cluster 1 in the Southeast (87.5%), Northeast (85.4%) and South (82.7%) regions. The majority of OHTs have satisfactory management and organisation. However, some need improvement, mainly in planning and programming actions based on health indicators and self-evaluation. All Brazilian OHTs need to participate in PMAQ-AB and it is important to continue evaluating the data to improve oral health care.
The Brazilian healthcare system, known as the Unified Health System (UHS) (Sistema Único de Saúde–SUS, in Portuguese) was implemented through the 1988 Federative Constitution of Brazil. In accordance with Primary Health Care (PHC) and based on the proposals made at the Alma Ata Conference in 1978, the main objective of the UHS is the promotion and universalisation of public health care to the whole population, the realisation of preventive actions and coordination of care based on social context [1,2,3].
The study was submitted to and approved by the Human Research Ethics Committee of the Universidade Federal de Minas Gerais, Brazil (protocol number 02396512.8.0000.5149).
The final sample was composed by 18,114 OHTs (77.9%).
This study shows the organisation of the work processes of Brazilian OHTs that participated in PMAQ-AB between 2013 and 2014. The majority of the teams organise work processes by planning and programming actions according to community contexts, self-evaluations and team agendas. The majority of OHTs showed good work process performances; however, others must be improved in order to develop an appropriate intervention program.