Quality Assessment in Primary Health Care

Abstract

The present article presents the current stage of the evaluative studies related to basic/primary health care being developed at the Center for Collective Health Studies (NESC/UFRN) in its role as a Collaborating Center of the State Health Secretariat of Rio Grande do Norte. We seek to evaluate the processes of change and the impact of Family Health Strategies (ESF) on the conversion of the health care model, in an attempt to institutionalize the monitoring and assessment of health actions. The Improved Quality Assessment (AMQ-MS) has innovated municipal health self-assessment. The case-study method was selected due to the need of examining a set of variables indispensable for understanding a complex phenomenon. Municipalities were assessed by AMQ instruments as well as by others previously validated in a regional study coordinated by the author (NESC/UFRN, 2006). Three large dimensions - political/institutional, organization of health care and total health care - are analyzed and then articulated in the assessment of the ESF implementation process, with strong contextualization of the effects. One of the dimensions of result analysis, in the broad sense, involves verifying system performance: reviewing the achievement of goals and results. We are currently working with twentythree indicators when analyzing municipal health system performance. The advent of analytic procedures has reduced the dimensionality of the data banks, resulting in a synthesis of the relative strength and explicative capacity of these indicators. Finally, we highlight the successful and strengthening aspects in the development of this experience of monitoring and evaluating basic primary health care.