Health practices in the reorientation of primary care in Rio de Janeiro State, Brazil, from the perspective of users and health professionals

This evaluative study focused on expansion of the Family Health Strategy in large cities in Rio de Janeiro State, Brazil. The study analyzed the functionality of health care modalities, performance, and supply of comprehensive care itself and its link to services at other levels. The thrust of the analysis was comprehensiveness of care in the daily routine of health services, with a focus on childbearing-age women, and with pregnancy as the tracer condition. The results emerged from an analysis of focus groups with health care users and health professionals, based on: characterization of key actors; their perceptions concerning health, health-care model, and organization of primary care services and practices. The groups suggested that the actors perceive health as identified with social determinants. Access to services and actions was differentiated in the family health unit by enrollment of the clientele and active search, and the study showed the lack of a structured network. The study indicates that work processes contemplating the social determination of health and its intersectorality can lead to expanded access to comprehensive care for childbearing-age women.