Primary Health Care in Northern and Northeastern Brazil: mapping team distribution disparities

Soares Filho, Adauto Martins; Vasconcelos, Cíntia Honório; Dias, Alexsandro Cosme; Souza, Ana Célia Caetano de; Merchan-Hamann, Edgar; Silva, Maria Rocineide Ferreira da

doi:10.1590/1413-81232022271.39342020

Adauto Martins Soares Filho

Programa de Pós-Graduação em Saúde Coletiva, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil. rocineideferreira@gmail.com

Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília DF Brasil.

https://orcid.org/0000-0002-0917-7473

Cíntia Honório Vasconcelos

Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília DF Brasil.

https://orcid.org/0000-0002-9635-0501

Alexsandro Cosme Dias

Programa de Pós-Graduação em Saúde Coletiva, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil. rocineideferreira@gmail.com

https://orcid.org/0000-0002-8784-1202

Ana Célia Caetano de Souza

Hospital Universitário Walter Cantídio, Universidade Federal do Ceará. Fortaleza CE Brasil.

https://orcid.org/0000-0001-9480-7195

Edgar Merchan-Hamann

Programa de Pós-Graduação em Saúde Coletiva, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil. rocineideferreira@gmail.com

https://orcid.org/0000-0001-6775-9466

Maria Rocineide Ferreira da Silva

Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual do Ceará. Fortaleza CE Brasil.

https://orcid.org/0000-0002-6086-6901

Collaborations

AM Soares Filho and CH Vasconcelos contributed to the study conception and design and data acquisition, analysis, and interpretation. All authors contributed to the drafting of the preliminary versions, approved the final version of the paper, and declared themselves responsible for all aspects of the work, in order to ensure that issues related to the accuracy or integrity of any part of the work are properly investigated and resolved.

Chief Editors:

Romeu Gomes, Antônio Augusto Moura da Silva

		ACS (per 1,000 inhabitants)		ESF (per 10,000 inhabitants)		ESB^a (per 10,000 inhabitants)		NASF^b (per 100,000 inhabitants)
		North	Northeast	North	Northeast	North	Northeast	North	Northeast
Total		2.5 (2.2; 2.8)	2.3 (2.1; 2.5)	3.0 (2.0; 3.9)	3.8 (3.1; 4.4)	1.9 (1.0; 1.3)	3.2 (2.1; 4.1)	2.9 (0.0; 8.5)	5.6 (2.8; 10.7)
Capital
	Yes	0.8 (0.5; 1.5)	0.9 (0.5; 1.4)	1.5 (0.8; 1.7)	1.4 (0.9; 2.2)	0.5 (0.1; 1.1)	0.9 (0.4; 1.6)	0.5 (0.2; 1.0)	0.6 (0.3; 1.2)
	No	2.6 (2.2; 2.9)	2.3 (2.1; 2.5)	3.0 (2.1; 3.9)	3.8 (3.1; 4.4)	1.9 (1.0; 3.1)	3.2 (2.1; 4.1)	3.0 (0.0; 8.6)	5.6 (2.9; 10.8)
Metropolitan
	Yes	2.5 (2.1; 2.7)	2.3 (2.0; 2.4)	3.3 (2.5; 3.9)	3.8 (3.0; 4.4)	2.5 (1.5; 3.7)	3.6 (2.4; 4.2)	5.7 (2.4; 13.2)	5.9 (3.2; 12.9)
	No	2.6 (2.2; 2.9)	2.3 (2.1; 2.5)	2.9 (2.0; 3.9)	3.8 (3.1; 4.4)	1.8 (0.9; 2.9)	3.1 (2.1; 4.1)	2.4 (0.0; 7.1)	5.6 (2.7; 10.1)
Population size
	<20 thousand	2.7 (2.4; 3.0)	2.4 (2.2; 2.6)	3.6 (3.0; 4.2)	4.1 (3.6; 4.7)	2.7 (1.7; 3.7)	3.8 (2.8; 4.4)	6.5 (0.0; 16.3)	8.3 (5.5; 15.2)
	20 a 50 thousand	2.4 (2.0; 2.7)	2.2 (2.0; 2.4)	2.2 (1.7; 2.8)	3.3 (2.8; 3.8)	1.4 (0.7; 2.0)	2.5 (1.6; 3.3)	2.3 (0.0; 3.9)	3.6 (2.6; 4.5)
	50 a 100 thousand	2.2 (1.7; 2.5)	2.0 (1.8; 2.3)	1.7 (1.2; 2.4)	2.7 (2.2; 3.1)	0.9 (0.5; 1.4)	1.6 (1.2; 2.5)	1.3 (0.2; 2.0)	2.0 (1.5; 3.2)
	100 a 200 thousand	1.7 (1.2; 1.9)	1.7 (1.4; 1.9)	2.0 (1.2; 2.1)	2.4 (1.9; 2.8)	0.8 (0.6; 1.3)	1.6 (0.8; 1.9)	1.2 (0.9; 1.8)	1.7 (0.9; 2.3)
	200 thousand +	1.1 (0.7; 1.6)	1.3 (1.0; 1.7)	1.4 (0.8; 1.8)	1.7 (1.2; 2.4)	0.4 (0.1; 0.8)	1.0 (0.6; 1.5)	0.3 (0.1; 0.7)	1.2 (0.5; 2.2)

	ACS (per 1,000 inhabitants)		ESF (per 10,000 inhabitants)		ESB^a (per 10,000 inhabitants)		NASF^b (per 100,000 inhabitants)
	Median	(Quartiles Q1-Q3)	Median	(Quartiles Q1-Q3)	Median	(Quartiles Q1-Q3)	Median	(Quartiles Q1-Q3)
Acre	2.5	(2.2; 2.7)	3.4	(3.0; 3.8)	2.6	(1.7; 3.0)	4.9	(2.4; 5.7)
Amapá	1.9	(1.5; 2.5)	3.5	(2.7; 4.0)	3.0	(2.2; 4.0)	5.7	(1.6; 11.5)
Amazonas	2.8	(2.4; 3.1)	3.2	(2.7; 3.9)	1.6	(1.3; 3.0)	3.3	(0.0; 6.0)
Pará	2.9	(2.6; 3.2)	3.6	(2.6; 4.3)	2.8	(1.7; 3.5)	4.4	(0.0; 6.5)
Rondônia	2.7	(2.3; 3.1)	3.2	(2.4; 4.2)	1.1	(0.6; 1.8)	0.0	(0.0; 0.0)
Roraima	2.3	(2.0; 2.6)	3.8	(3.3; 4.1)	3.3	(1.9; 4.0)	7.5	(2.7; 9.2)
Tocantins	2.7	(2.4; 3.0)	3.7	(3.3; 4.3)	3.3	(2.2; 4.0)	14.4	(7.9; 24.5)
Alagoas	2.4	(2.3; 2.6)	4.0	(3.6; 4.4)	3.7	(2.8; 4.2)	9.2	(6.7; 14.3)
Bahia	2.3	(2.1; 2.5)	3.7	(3.3; 4.2)	2.7	(2.0; 3.5)	6.2	(3.4; 8.3)
Ceará	2.3	(2.1; 2.4)	4.1	(3.6; 4.4)	3.3	(2.5; 4.0)	6.1	(5.1; 8.0)
Maranhão	2.8	(2.7; 3.1)	3.8	(3.5; 4.3)	3.0	(2.3; 3.7)	5.7	(1.2; 8.5)
Paraíba	2.3	(2.2; 2.5)	4.3	(3.9; 4.8)	4.1	(3.7; 4.6)	13.8	(7.0; 21.1)
Pernambuco	2.3	(2.0; 2.4)	3.9	(3.4; 4.4)	3.4	(2.5; 4.3)	6.7	(5.0; 8.6)
Piauí	2.5	(2.4; 2.6)	4.7	(4.4; 5.1)	4.6	(4.2; 5.1)	16.5	(10.4; 22.2)
Rio Grande do Norte	2.3	(2.1; 2.5)	4.4	(3.8; 4.9)	4.2	(3.7; 4.8)	12.3	(7.7; 21.7)
Sergipe	2.3	(2.0; 2.3)	3.6	(3.1; 4.3)	3.1	(2.2; 3.6)	0.0	(0.0; 9.3)

	ACS (per 1,000 inhabitants)		ESF (per 10,000 inhabitants)		ESB^a (per 10,000 inhabitants)		NASF^b (per 100,000 inhabitants)
	Capital	Non capital	Capital	Non capital	Capital	Non capital	Capital	Non capital
Acre	1.5	2.4	1.6	3.4	0.7	2.6	0.5	4.4
Amapá	0.8	1.9	1.1	3.1	0.4	2.7	1.0	4.3
Amazonas	0.5	2.7	0.8	2.8	0.4	1.6	0.1	2.8
Pará	0.4	2.5	0.7	2.3	0.1	1.2	0.7	1.2
Rondônia	0.8	2.3	1.5	2.9	1.1	0.8	0.2	0.0
Roraima	0.9	2.3	1.7	3.7	0.0	3.3	0.3	6.6
Tocantins	1.7	2.6	2.7	3.8	2.0	3.1	2.3	13.5
Alagoas	0.5	2.3	0.8	3.7	0.4	3.2	0.6	6.3
Bahia	0.4	2.2	0.8	3.3	0.4	2.2	0.3	4.0
Ceará	0.8	2.2	1.4	3.6	0.9	2.7	0.2	4.3
Maranhão	0.7	2.8	1.0	3.6	0.4	2.6	1.2	4.0
Paraíba	1.8	2.3	2.4	4.2	2.2	4.0	4.1	11.9
Pernambuco	1.2	2.1	1.6	3.3	0.9	2.6	1.2	3.9
Piauí	1.6	2.5	3.0	4.7	2.7	4.5	0.4	15.2
Rio Grande do Norte	0.5	2.3	0.9	4.3	0.7	4.1	0.3	10.0
Sergipe	1.2	2.2	1.9	3.4	1.1	2.7	1.2	1.2

[1] Collaborations

AM Soares Filho and CH Vasconcelos contributed to the study conception and design and data acquisition, analysis, and interpretation. All authors contributed to the drafting of the preliminary versions, approved the final version of the paper, and declared themselves responsible for all aspects of the work, in order to ensure that issues related to the accuracy or integrity of any part of the work are properly investigated and resolved.

Brasil

Brasil

Primary Health Care in Northern and Northeastern Brazil: mapping team distribution disparities

Abstract