Gestão municipal da atenção primária em saúde no contexto da pandemia de covid-19 no estado da Paraíba

Abstract

The Covid-19 pandemic has emphasized the need to strengthen Primary Health Care (PHC). This study aims to understand how municipal managers have managed PHC actions and their challenges during the Covid-19 pandemic in the municipalities of Paraíba, Brazil. It is an exploratory cross-sectional study with a descriptive and analytical nature. The results presented here consist of primary data collected through a questionnaire via an electronic survey conducted between August 2023 and January 2024. The target audience was PHC secretaries and coordinators working in the management of municipalities in Paraíba. This study included 222 respondents from 222 municipalities in the state of Paraíba, with only one municipality choosing not to participate. The majority of respondents were women aged 29 to 39. Regarding race/ethnicity, many identified as mixed-race and white. In terms of academic qualifications, more than half reported having completed specialized training, and there was a strong concentration of nursing professionals, with most participants being PHC coordinators. As for the measures adopted by municipal management in addressing the Covid-19 pandemic, respondents reported measures such as expanded disinfection routines, provision of hand hygiene resources in public spaces, mandatory mask-wearing in public and commercial spaces and on public transport, widespread Covid-19 testing, distribution of masks to the population, street and public space disinfection, and the development of a Contingency Plan. The data gathered highlights the challenge for PHC in coordinating care and organizing the Health Care Networks (RAS), significantly impacting the daily work of managers during the Covid-19 pandemic. The importance of collaboration between the State Health Secretariat of Paraíba (SES-PB), the Municipal Health Secretariats of Paraíba (COSEMS-PB), and the Ministry of Health is observed as crucial support for municipal PHC management during health crises. It is concluded that PHC in Paraíba played a significant role in addressing Covid-19-related demands during the pandemic. The main challenges for PHC managers are related to implementing the attributes of PHC as care coordinators and organizers of RAS. These challenges point to potential recommendations that could contribute to a community.