Structure and responsiveness: are Primary Health Care Units prepared to face COVID-19?

Collaborators

Furlanetto DLC (0000-0002-5703-7520)^* * Orcid (Open Researcher and Contributor ID). , Santos W (0000-0001-5705-936X)^* * Orcid (Open Researcher and Contributor ID). , Scherer MDA (0000-0002-1465-7949)^* * Orcid (Open Researcher and Contributor ID). , Oliveira KHD (0000-0002-3600-4009)^* * Orcid (Open Researcher and Contributor ID). and Santos LMP (0000-0002-6739-6260)^* * Orcid (Open Researcher and Contributor ID). contributed to the conception and planning, to the analysis and interpretation of data; to the writing and review of the article; critical review of the intellectual content. Cavalcante FV (0000-0002-8706-0457)^* * Orcid (Open Researcher and Contributor ID). , Oliveira A (0000-0002-3084-6491)^* * Orcid (Open Researcher and Contributor ID). , Santos RR (0000-0003-1202-3579)^* * Orcid (Open Researcher and Contributor ID). , Leite TA (0000-0001-9307-4807)^* * Orcid (Open Researcher and Contributor ID). and Poças KC (0000-0002-1254-8001)^* * Orcid (Open Researcher and Contributor ID). contributed to the interpretation of data; to the writing and review of the article; critical review of the intellectual content. All the authors approved the final version of the manuscript.

Regulation/ Technical Document	Description	Source
National Program for Improving Access and Quality in Primary Care	The PMAQ/AB intends to increase the transfer of funds from the Federal level to participating municipalities, aiming at improving the quality of health services through the qualification, monitoring, and evaluation of work processes.	(a₁) (a₂)
Self-assessment for improving access and quality of primary care	The AMAQ/AB instrument was developed in the context of the ‘Health Closer to You’ program, from which the PMAQ was developed, with the objective of encouraging the evaluation of primary care.	(b)
Physical structure manual of Primary Health Care Units	It aims to assist in the conception and strengthening of the Family Health Strategy (FHS), suggesting the elaboration of renovation, construction, and expansion of PHC Units projects to enable the physical structure to facilitate the improvement of health practices.	(c)
Ordinance No. 77, of Feb 14, 2017, which establishes the PHC Policy of the Federal District. DODF No. 33, Section1, 2, and 3, Feb 15, 2017.	Establishes the Federal District´s Primary Health Care Policy: principles, guidelines, administrative organization of teams, PHC Units, management of PHC and organization of services in the territory, planning, monitoring, and evaluation of health actions, patient access, reception, and risk classification. The organization of the work schedule and agenda, the supply of medicines and health products, collection of tests, organization of vaccination, regulation for specialties, transport, permanent health education and health surveillance.	(d)
DF Contingency Plan for Human Infection by the Novel Coronavirus	Characterizes the degree of response and the organization of command to be made at each level of response to human infection by the Novel Coronavirus.	(e)
Technical Note COAPS/SAIS/SES. COVID-19 No. 01/2020 v2	Clinical and organizational support in addressing the Patient with Suspected Coronavirus Disease (COVID-19) in the PHC of the State Department of Health of the DF.	(f)
CONASS Healthcare network service during COVID-19 pandemic	It aims to provide instruments, guidance, management, and control of conditions in the healthcare service network during the COVID-19 pandemic.	(g)
WHO case management of COVID-19 in health facility and community	Intended for decision-makers, aiming at improving the care of patients with COVID-19 regarding treatment, without compromising the actions of public health services and health professionals.	(h)
Health Care Protocol: PHC Nursing Guide	Description of Standard Operating Procedures and their flowcharts in nursing care in PHC.	(i)
Technical Report of Primary Care No. 01 Brasília, Aug 4, 2020	Characterization of the role of Family Health Teams in the prevention, control, and management of COVID-19.	(j)

Description of structure, inputs and procedures of Primary Health Care Units^a a All the 165 Primary Health Care (PHC) Units operating in Brasília responded the survey	N	Proportion %
There are health workers at the entrance of PHC Units to identify and assist the reception of SRP/COVID-19 suspects	146	88.5
The professional assigned for SRP reception is the community health worker	118	80.9^b b Proportion relative to 146 PHC Units with reception procedures for SRP
The health workers perform the SRP/COVID-19 suspects risk classification	135	81.8
There is an adequate external space for the SRP/COVID-19 suspects to wait for assistance	135	81.8
There is an internal space reserved only for the SRP/COVID-19 suspects, far from the service rooms of other patients	99	60.0
There are ventilated consultation offices dedicated exclusively to SRP/COVID-19 suspects care	134	81.2
The offices have a sink with soap and water to allow frequent hand hygiene	112	67.9
There are PFF2, or N95 masks in sufficient quantity for the entire month	144	87.3
There are disposable surgical masks in sufficient quantity for the entire month	155	93.9
The SRP receive surgical masks when they attend the Primary Health Care Unit	109	66.1
The health workers use procedure gloves correctly and frequently	146	88.5
The Family Health Teams conduct active search for new SRP/COVID-19 suspects	150	90.9
The active searches are conducted by phone or mobile	132	88.0^c c Proportion relative to 150 PHC Units with active search for new SRP.
The active searches are conducted by home visits	67	44.6^c c Proportion relative to 150 PHC Units with active search for new SRP.

Description of structure, inputs, and procedures of Primary Health Care Units^a a Number of UBS operating in Brasília that filled the survey: 159 (out of 165)	N	Proportion %
COVID-19 rapid tests are available in sufficient quantity for the entire month^b b Rapid test was the common name for COVID-19 antibody test in 2020	103	64.8
COVID-19 swab tests are available in sufficient quantity for the entire month^c c Swab test was the common name for RT-PCR test in 2020.	120	75.5
The PHC Unit has an emergency cart with all the necessary supplies and equipment in working order, with a checklist, and sealed.	142	89.3
The Family Health Teams received training and/or guidance on the clinical management of COVID-19 in PHC	137	86.2
The Family Health Teams received training on how to advise the population on COVID-19 prevention measures	141	88.7
The PHC Unit has information material about COVID-19 aimed at patients	110	69.2
The PHC Unit offers Telehealth services during the pandemic	91	57.2
There are established flows of patient transfer to the secondary care level	136	85.5
There are established flows of patient transfer to the hospital care level	149	93.7
The established flows are adequate to address the transfer needs of patients	108	67. 9
The teams notify suspected cases of COVID-19 in the defined surveillance systems (e-SUS VE, SIVEP/Gripe)	155	97.5
The percentage of SRP consultations in relation to the total number of consultations is monitored	112	70.4

[1] Conflict of interests: non-existent

Brasil

Brasil

Structure and responsiveness: are Primary Health Care Units prepared to face COVID-19?

ABSTRACT