Avaliação da qualidade do controle do câncer de colo uterino na Atenção Primária à Saúde em municípios baianos.

Abstract

This is a multiple case study, with the objective of evaluating the quality of primary health care through cervical cancer control actions in two municipalities in the state of Bahia. This study is part of the Research Project “Analysis of the implementation of the Program to Improve Accessand Quality of Primary Health Care (PMAQ-AB) in the State of Bahia from 2012 to 2017”, developed by the ISC/UBFA with funding from the Ministry of Health. Two municipalities with small populations with high coverage of the Family Health Strategy and adherence of all their teams to the third cycle of the PMAQ were selected and which obtained, respectively, the highest and lowest degree of implementation of the PMAQ. A normative assessment of quality was carried out through the matrix of indicators, using structured data from the external evaluation of the 1st and 3rd Cycles of the PMAQ-AB. In a second moment, the organization and execution of uterine cancer control actions at the municipal level were analyzed according to the perception of managers and health professionals and document analysis, compared with the aforementioned normative assessment. And finally, the government capacity of the professionals responsible for organizing and offering uterine cancer control actions in the two municipalities studied was investigated according to normative assessment data, interviews and document analysis. The main findings indicate that: the municipalities studied showed an improvement in the quality of cervical cancer control in the PHC in the period between the 1st and 3rd cycles of the external evaluation of the PMAQ-AB, a more evident result in municipality A, while in municipality B, only 20% of the teams evaluated in the 3rd cycle adequately carried out actions and strategies for screening and early diagnosis. Municipality A, which presented the best quality indicators, demonstrated a more robust government capacity regarding the profile of professionals, evidenced by the functional stability, previous experience in PHC and complementary training in collective health of the interviewees, alongside the regular development of actions of institutional support to the Family Health teams. The results also showed some weaknesses in the organization of the cervical cancer care line in the regional health network, converging with other scientific productions on the subject.