Indicadores de desempenho da atenção primária à saúde (Previne Brasil) em Alagoas, Brasil: uma análise de situação durante o primeiro ano da pandemia de Covid-19 (2020)

Abstract

Introduction: in 2019, a new financing model for Primary Health Care (PHC) was launched – the ‘Programa Previne Brasil’. At the end of that same year, a new coronavirus emerged that resulted in a pandemic, declared on March 11, 2020 by the World Health Organization, with impact all components of the health system– from primary to tertiary care. Objective: to analyze the performance indicators of primary health care (Previne Brasil) in Alagoas, Brazil, during the first year of the Covid-19 pandemic. Methods: an ecological study, with the municipalities of Alagoas as units of analysis, where seven PHC performance indicators were analyzed in the three four-month periods of 2020. For the comparative analysis of the four-month periods, Friedman's nonparametric test was used and for the spatial analysis, Moran's Global and Local statistics are used. The study did not need to be considered by the Research Ethics Committee, given that it used data in the public domain. Results: a technical report was generated where no difference in the performance of the municipalities in the three quarters in the following indicators: proportion of pregnant women with at least 6 (six) prenatal consultations performed, proportion of pregnant women with dental care performed and coverage of Pap smear. No municipality reached the goal related to the percentage of hypertensive people with blood pressure measured in each semester and, regarding the percentage of diabetics with request for glycated hemoglobin, only two municipalities reached the goal in the third four months. The state's median ISF in the first quarter (3.6; IQR 1.5) was lower than that observed in the second (4.2; IQR 1.6) and in the third quarter (4.4; IQR 2.1) ( p < 0.001). Between the second and third quarters, no difference was observed (p = 0.060). In this indicator, a cluster composed of seven municipalities with the best performance was observed in the southern region and a cluster composed of five municipalities with the worst performance was recorded in the north of the state. Conclusion: the goals of the Previne Brasil indicators were not achieved by the vast majority of Alagoas municipalities. It is recommended that support plans for municipalities can be developed and implemented by the state.