Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program
Market-led economic reforms are usually viewed as being in conflict with government-stimulated socioeconomic development for disadvantaged groups. Nevertheless, Ceará, a poor state in the Northeast of Brazil, has since 1987 pursued both of those strategies simultaneously. One part of that approach h...
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Pan American Health Organization
2000
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ftdoajarticles:oai:doaj.org/article:fce446ed36e244a2a16d9a9d89272375 2023-05-15T15:18:36+02:00 Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program Ennio Cufino Svitone Richard Garfield Maria Ines Vasconcelos Villane Araujo Craveiro 2000-05-01T00:00:00Z https://doi.org/10.1590/s1020-49892000000500002 https://doaj.org/article/fce446ed36e244a2a16d9a9d89272375 EN ES PT eng spa por Pan American Health Organization http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892000000500002&lng=en&tlng=en https://doaj.org/toc/1020-4989 1020-4989 doi:10.1590/s1020-49892000000500002 https://doaj.org/article/fce446ed36e244a2a16d9a9d89272375 Revista Panamericana de Salud Pública, Vol 7, Iss 5, Pp 293-301 (2000) Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2000 ftdoajarticles https://doi.org/10.1590/s1020-49892000000500002 2022-12-31T00:53:40Z Market-led economic reforms are usually viewed as being in conflict with government-stimulated socioeconomic development for disadvantaged groups. Nevertheless, Ceará, a poor state in the Northeast of Brazil, has since 1987 pursued both of those strategies simultaneously. One part of that approach has been a program of nurse-directed auxiliary health workers serving about 5 million people--almost all the persons outside the capital city and half of those in the capital. The system requires that the auxiliaries, called agentes de saúde, live in the local communities that they serve. The health agents visit each home once a month to carry out a small number of priority health activities. While health agent positions are in high demand, the minimum-wage salary that the agents receive makes up only a small portion of the state budget. A key aspect of the system is timely and comprehensive information, which is based on agent visits and is managed by trained nurses. Since the health agents system was launched, there has been a rapid decline in infant mortality, a rapid rise in immunization, identification of bottlenecks limiting the utilization of other medical resources, and timely interventions in times of crisis. The health agents system has combined administrative decentralization with financial centralization during a period of electoral democratization. The system has strengthened Ceará's commitment to primary care even as market-oriented changes have reduced the overall role of government. The Ceará program is being copied throughout the Northeast and other regions of Brazil. The key role that nurses play in the Ceará program in organizing and leading a system of basic primary care in poor neighborhoods and rural areas may provide useful lessons for other countries. In addition, Ceará does not have many of the favorable characteristics of other countries that have successfully invested in primary health care. Ceará thus represents a more achievable model for other countries, where, like Brazil, income, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista Panamericana de Salud Pública 7 5 293 301 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Spanish Portuguese |
topic |
Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Ennio Cufino Svitone Richard Garfield Maria Ines Vasconcelos Villane Araujo Craveiro Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program |
topic_facet |
Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Market-led economic reforms are usually viewed as being in conflict with government-stimulated socioeconomic development for disadvantaged groups. Nevertheless, Ceará, a poor state in the Northeast of Brazil, has since 1987 pursued both of those strategies simultaneously. One part of that approach has been a program of nurse-directed auxiliary health workers serving about 5 million people--almost all the persons outside the capital city and half of those in the capital. The system requires that the auxiliaries, called agentes de saúde, live in the local communities that they serve. The health agents visit each home once a month to carry out a small number of priority health activities. While health agent positions are in high demand, the minimum-wage salary that the agents receive makes up only a small portion of the state budget. A key aspect of the system is timely and comprehensive information, which is based on agent visits and is managed by trained nurses. Since the health agents system was launched, there has been a rapid decline in infant mortality, a rapid rise in immunization, identification of bottlenecks limiting the utilization of other medical resources, and timely interventions in times of crisis. The health agents system has combined administrative decentralization with financial centralization during a period of electoral democratization. The system has strengthened Ceará's commitment to primary care even as market-oriented changes have reduced the overall role of government. The Ceará program is being copied throughout the Northeast and other regions of Brazil. The key role that nurses play in the Ceará program in organizing and leading a system of basic primary care in poor neighborhoods and rural areas may provide useful lessons for other countries. In addition, Ceará does not have many of the favorable characteristics of other countries that have successfully invested in primary health care. Ceará thus represents a more achievable model for other countries, where, like Brazil, income, ... |
format |
Article in Journal/Newspaper |
author |
Ennio Cufino Svitone Richard Garfield Maria Ines Vasconcelos Villane Araujo Craveiro |
author_facet |
Ennio Cufino Svitone Richard Garfield Maria Ines Vasconcelos Villane Araujo Craveiro |
author_sort |
Ennio Cufino Svitone |
title |
Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program |
title_short |
Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program |
title_full |
Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program |
title_fullStr |
Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program |
title_full_unstemmed |
Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program |
title_sort |
primary health care lessons from the northeast of brazil: the agentes de saúde program |
publisher |
Pan American Health Organization |
publishDate |
2000 |
url |
https://doi.org/10.1590/s1020-49892000000500002 https://doaj.org/article/fce446ed36e244a2a16d9a9d89272375 |
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Arctic |
geographic_facet |
Arctic |
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Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 7, Iss 5, Pp 293-301 (2000) |
op_relation |
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892000000500002&lng=en&tlng=en https://doaj.org/toc/1020-4989 1020-4989 doi:10.1590/s1020-49892000000500002 https://doaj.org/article/fce446ed36e244a2a16d9a9d89272375 |
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https://doi.org/10.1590/s1020-49892000000500002 |
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