Monitoring and evaluation of primary health care attributes at the national level: New challenges

Abstract

Five new challenges were brought to the federal management of SUS from the estab-lishment of the Primary Health Care Secretariat (SAPS) in May 2019, as follows: a) to expand peo-ple’s access to health facilities; b) to define a new financing model from health outcomes and effi-ciency; c) to define a new model of provision and training of family and community doctors for re-mote areas; d) to strengthen clinic and multi-pro-fessional teamwork; e) to expand computerization of health facilities and use of electronic medical records. This essay discusses these elements in light of a new evaluation model that also guides a new process of financing the Brazilian Primary Health Care (PHC). It builds on the correction of distrib-utive distortions, and also seeks to guide greater effectiveness and efficiency in public investment and quality of service provided to the population. The proposal for a new PHC evaluation and financing model was elaborated through studies of the best international examples and discussion with representatives of the National Council of State Health Secretaries (CONASS) and the National Council of Municipal Health Secretaries (CONASEMS), and with technical support from the World Bank.