The construction of the primary health care organizational model index to fight COVID-19: scope, limits and perspectives in the Brazilian remote rural context
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University of Sao Paulo, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A361
Background and Objective: The socio-spatial singularities of remote rural locations are rarely recognized in their classification; nor are they remembered in the formulation and implementation of public policies. These must prioritize the conditions of access to health, the form of organization of Primary Health Care (PHC) services and practices and the workforce attraction, molded in relation to local contexts, far beyond a simple opposition to the urban locale. In the context of fighting against the covid-19 pandemic, cohesion between political initiatives, organization of services and health surveillance are essential, based on the power and capillarity of PHC. Our aim is to contextualize the creation of the organizational model index for coping with Covid-19 and to analyze its application in the Brazilian rural remote municipalities. Methods: Document and statistical analysis, including correlations, factorial and consistency analysis and logistic regression, from the construction of the instrument to its application. The index consists of six dimensions: Political Conduct, Social Isolation, Border Surveillance, Case Surveillance, Service Organization and Social Support. Results: The determining variables for success in combating the pandemic were the state of alert for the high case rate, lower death rate than the state of origin and longer time to define containment strategies, with two sets of protectors: wealthier localities, with a lower % of income transfer or higher Family Health Strategy coverage and PHC services density. Health surveillance was essential in case detection, along with specialized care, and in the identification of deaths, with both rates being higher in the Midwest and Amazon regions. Conclusions: The index successfully discriminated the different remote rural typologies, with a gradient being observed between the Midwest region and Northern Minas Gerais state; with the best results, whereas the Amazon region presented intermediate levels, followed by the new northeastern agricultural frontier and the northeastern Semiarid region.