Association between human development and primary health care productivity in Brazil: a retrospective ecological study

Abstract

Objective: To investigate the association between the Municipal Human Development Index (IDHM) and the productivity of Primary Health Care (PHC), measured by the Final Synthetic Index (ISF). Methods: This observational, retrospective, ecological study conducted a quantitative analysis of data from 5,564 Brazilian municipalities. Data were obtained from the Primary Health Care Indicators Panel and Base dos Dados. Descriptive statistics and linear correlation techniques were employed. Results: The analysis identified a weak negative correlation between IDHM and ISF (r = –0.17, p < 0.001). Regional analyses revealed heterogeneous patterns. In the Central-West (r = –0.03; p = 0.581) and South (r = 0.06; p = 0.042), the association was essentially null. Conversely, the Southeast (r = –0.20; p < 0.001) and Northeast (r = –0.14; p < 0.001) showed negative correlations. The North was the only region with a positive association (r = 0.31; p < 0.001). Conclusion: The findings suggest that, although lower human development is associated with higher PHC productivity, health policies must account for local contextual factors to enhance service effectiveness.