Sixteen years of primary health care monitoring in a large metropolis in the Americas

Abstract

The present article describes the institutional integration of primary health care (PHC) performance monitoring in a metropolis in the Americas where 7 million people use the public health care system. Based on the development, 16 years ago, of the São Paulo City Health Department Monitoring Panel, a PHC Management Panel was developed, providing information on the behavior of a set of selected indi-cators at this level of care over time. The Management Panel was incorporated into the process of governance reorganization, involving management and technical staff at various levels, who were trained in a co-management method with support from the Pan American Health Organization/World Health Organization (PAHO/ WHO). The experience with the Management Panel was also useful to increase the effectiveness with which the information provided by the Monitoring Panel was communicated, supporting the implementation of changes in the organizational model to consolidate the PCH attributes of access, longitudinality, comprehensiveness, and coordination of care. The robustness of the historical data series and the involvement of the implementers of this initiative helped to increase trust in the information generated. The monitoring method captured changes over time and guided those in-volved regarding the differences between city regions. Monitoring is a strategy that enables the swift and timely use of secondary data, and was essential to meet the challenges identified in this health care system.