Analysis of the evaluation of the FHP small cities

Abstract

The Family Health Program (FHP) plays an important role in the strengthening of basic care in the Brazilian public health system. Currently the FHP is spreading over the Brazilian cities and regions, being implemented with different intensity and in different forms, reflecting the diversity of the country itself. In 2005, the Ministry of Health (MH) proposed evaluating the Family Health Program by means of specific questionnaires. The aim of this descriptive reflective study is to conduct a critical analysis of the instrument proposed by the Ministry of Health for evaluating the FHP in the light of the specialized literature. The proposed quantitative evaluation methodology is limiting the comprehension of the different local contexts. Moreover, there is a lack of user-based evaluation as refers to the quality of the delivered services. Another important limitation is that the participation of the municipal administrations in the evaluation is optional. On the other hand, the proposal of the Ministry has the merit of representing a specific and systematized self-evaluation process for the FHP, integrating the opinion of different actors in a methodological approach traditionally accepted for evaluating the quality of health actions. The integration of the municipal administrations to the Evaluation and Monitoring Plan of the states has the advantage of involving the states in the harmonization of regional inequalities and in the solution of possible technical deficiencies and/or management difficulties on municipal level. The functionality and resolutivity of the evaluation methodology proposed by the Ministry of Health will certainly play an important role in the strategic decision-making of public managers and health teams.