Management model of primary health services and interprofessional practice in Brazil

Abstract

Brazilian primary health care is organized by decentralized Family Health Strategy composed with interprofessional teams. This study focused on finding out how are the relationship between the management model of primary health services and interprofessional practice.Qualitative study, part of a mixed-methods sequential explanatory design. Thirteen semi-structured interviews were conducted with health managers from six Brazilian municipalities. Data were collected between October and December 2018 and applied content analysis.The results allow three major content categories, 1) “Characteristics of management models to support interprofessional practice”: continuous communication among managers, health care professional and patients is the principal attribute of management. The interviewed mentioned the need to communicate with teams using regular meetings and technological resources. They recognize the availability of interprofessional practice in favour of dialogue, shared decision and physical space. In order to patient engagement, they adopted open communication with patients focused on spontaneous demands. 2)”Management actions for comprehensive care”: the interviewed recognized the lack of services integration and interprofessional teams. They mentioned participatory management strategies as team meetings in health services and engagement in public health council to shared health planning. 3)”Challenges for management interprofessional practice”: Challenges considered the lack of permanent policies focused on patient needs, frequent changes of the municipal managers and health care professionals, the lack of planning actions, and the need to meet spontaneous management demands.Management practices can support interprofessional practice and comprehensive care however challenges are related to non-permanent policies, unplanning actions and spontaneous management demands.Communication is the principal attribute of the management model of primary health services to reinforce interprofessional practice.Compreehensive care depends on patient and interprofessional teamwork engagement for share decision making.