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Nursing challenges for universal health coverage: a systematic review1 1 Paper extracted from doctoral dissertation "Conceptions of health and care of integrative / complementary and humanizing practices in primary health care: a systematic review", presented to Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil and Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal. Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, process # 249381/2013-3.

Objectives

to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care.

Method

systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel.

Results

thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage.

Conclusions

nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage.

Nursing; Universal Access to Health Care Services; Humanization of Assistance; Primary Health Care; Review


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