Organization of Primary Health Care in a remote rural municipality in northern Brazil

ORGANIZACIÓN DE LA ATENCIÓN PRIMARIA DE SALUD EN UN MUNICIPIO RURAL REMOTO DEL NORTE DE BRASIL

Abstract

The objective of this article is to characterize the organization of Primary Health Care (PHC) and its interfaces with the other services of the care network in a Remote Rural Municipality (RRM). A single case study was conducted in Assis Brasil/AC through interviews with users, managers and health professionals. The results indicated an uneven distribution of health establishments with uncovered areas; difficulty in accessing health services due to climatic conditions; economic barriers to transport costs; promotion of itinerant health actions in rural area; discontinuity and insufficiency of medications; difficulties in retaining professionals; scarcity of technological resources; lack of internet access; need for cultural adaptation; concentration of specialized public services in the capital. Local management efforts were identified to maintain the Family Health Strategy (FHS) and adaptation of work processes to meet the large flow of spontaneous demand, foreigners and indigenous people. It is argued that RRM and its populations add up to economic, social and access vulnerabilities to health services, partially covered by national policies and that the municipal entity, without sufficient state and federal support and resources, maintains possible arrangements for the provision of PHC, not always adhering to the comprehensive principles that characterize the FHS.