Access and coverage of Primary Health Care for rural and urban populations in the northern region of Brazil

Abstract

Access inequities to the Unified Health System compromise the assurance of primary health care for  rural populations and other groups in situations of  vulnerability. A cross-sectional study that evaluated  users’ access and coverage of Family Health Teams  (FHT) from the seven states of the Northern region of  Brazil and that joined the external evaluation of the  second cycle of the National Program for Access and  Quality Improvement in Primary Care (PMAQ-AB). For the region as a whole, the assistance coverage of  teams based in rural, urban and urban areas that  declared covering rural populations was 83.3%.  Coverages between 90-100% were found for Acre,  Amapá, Roraima and Tocantins. Lower percentages  were found in Pará (50.5%) and Amazonas (60.5%).  The coverage extension hides geographical access  barriers related to the concentration of Family Health  Strategy teams in urban areas, a situation that  involves 451 (25.3%) units and 494 (22.9%) teams in  charge of serving rural populations, but which act in  urban area, adding barriers to the arrival of users to the units. Difficulties in welcoming spontaneous  demand, appointment scheduling and availability of  transportation for care were also reported.