Expansion of coverage of Primary Health Care: strategies and challenges of municipal management

Abstract

The expansion of Primary Health Care (PHC), mainly through the Mais Médicos Program (PMM), gained prominence in reducing the unequal distribution of doctors and managed to expand PHC coverage. The objective was to analyze the configurations of PHC, in the care network, and the strategies and challenges of municipal management in the process of its expanding. From a case study, whith a qualitative approach, in Tangará da Serra – MT, Brazil, combining primary and secondary data. Interviews with key informants from management and health services analyzed in the thematic aspect, organized into three categories: Context and organization of PHC in the care network, Strategies to organize the coordination of care in the expansion of PHC and Challenges for the management of the network of local attention. The results evidence of a hierarchical health system investment strategies in the information system, guidance to the population regarding the flow of care and strong teaching-service integration. The challenges focus on the sharing of care in the care network, low investment at the secondary level with reports of the use of private services. It is concluded that there is a need to strengthen health management, coordination of the health system and emphasis on training human resources.