Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: The few implementation reviews in Brazil shows a small use of telehealth services and more research is required to know its causes. The main goal of this work is to analyze the use rate of the asynchronous teleconsulting service in the Espírito Santo Telehealth Programme from 2012 to 2015, looking to the influence of the different strategies employed to promote its use. Methods: This descriptive study takes into account secondary data of the health professionals registered and the services of teleconsulting and web conferences produced. Results: In this period, 3076 health professionals were registered, where 381 (12.4%) requested 2182 teleconsulting (41.4% of them were requested by nurses), which corresponds to a low use rate. After statistical analysis, it was observed that: the use rate of teleconsulting is influenced by the regional workshops (increase in 15.5% in the number of teleconsulting users; p=0.037); management of heath professional registration has a limited impact; there is a strong positive correlation (r=0.73; p=0.016) between the use of the teleconsulting service and web conference participation; field monitoring may influence the use rate. Conclusion: Finally, this work confirms the low use rate of the Telehealth services, and recommends that centralizing the action plan at the end user is the key to promote its sustainability.

Introduction: Reports of cases of domestic violence against women are essential for the epidemiological dimensioning of this issue. Brazilian health units must carry them out, although these mandatory reporting have been repeatedly pointed out as not been made effective or done with many incompleteness. Objectives: To contribute to understand the subjective difficulties of reporting domestic violence against women by Brazilian primary health care professionals. Methods: A purposive sample of 14 primary health care professionals were interviewed; they had different educational backgrounds and worked in a countryside city of the state of São Paulo, Brazil. The transcripts of the semi-structured interviews, with open questions, underwent a content analysis. Results: The analysis resulted in six thematic categories: lack of knowledge of the means of notification; “appropriate” health services to notify; a police incident report as the main instrument of notification; notification would be optional; the role of notification for prevention and excessive bureaucracy. Discussion: The discussion raised the hypothesis of an opposition between an attitudinal readiness to serve women victims of violence and learn how to report these situations and, on the other hand, the lack of professional preparation to carry out the notifications; the opposition between to notify and to denunciate is also discussed, given the ambiguity of the terms used in the notification form and in the Brazilian Penal Code itself. Finally, it is discussed if violence against women is considered by the interviewees as a question for basic health care.

Despite the launch of the Doctors throughout Brazil Program (PMB) bring the idea of innovation, this article highlights the continuity of the current program in relation to the More Doctors Program (PMM). The PMB structures itself in the PMM’s settings to assemble its operating framework and attempts to overcome existing problems in the previous program. The main proposal of the PMB is the medical career to work in Primary Health Care (PHC), without, however, presenting other important elements for professional fixation. Thus, it presents itself as a more fragile policy than its predecessor, focusing only on the provision of doctors, at the risk of not achieving the objectives it has set itself as a public policy. In addition, through the proposal to create the Agency for the Development of Primary Health Care (Adaps), the program leaves room for the privatization of PHC services and the Unified Health System as a whole.

Carta dirigida ao editor da RBMFC a propósito de um caso clínico de Síndrome de PFAPA acompanhado nos Cuidados de Saúde Primários. Esta carta é enviada na sequência do artigo publicado pela RBMFC em 2019.

This editorial presents the result of the public call for articles that make up the special “Diversity and Human Rights in Primary Health Care”. The human rights situation in Brazil is worrying, with profound inequities in the full exercise of citizenship among social groups, including access to health services and maintenance of adequate and fair health levels. Racial, gender, sexuality, diversity, violence and human rights are becoming increasingly important in the context of primary health care (PHC) and Family and Community Medicine.The works published in this special point to the importance of thinking about the organization of an intersectional PHC and a comprehensive, welcoming, humanized, resolute and culturally and socially oriented health practice. Family and Community Medicine should produce more robust theoretical reflections to support care for people in severe situations of vulnerability and suffering. At the same time, the composition of RBMFC’s editorial board should have greater equity in gender, ethnicity and geography. We hope the content of this special will support the reflection on and construction of practices and policies able to face the deep and diverse social inequalities of the country, and that in the future we can count on a greater knowledge production in this field.  

On August 1, 2019, President Bolsonaro and his Minister of Health launched the Program Doctors throughout Brazil (Programa Médicos pelo Brasil) that will replace the Program More Doctors (Programa Mais Médicos). The purpose of this article is to contribute to an analysis of that latest primary care policy proposal in the context of the Program More Doctors and other development and qualification of the Family Health Strategy (FHS) in the country from 1994 to 2019.

Lancet Countdown: Tracking Progress in Health and Climate Change is an international multidisciplinary  collaboration that aims to monitor the relationship between public health and climate change. It brings together 35 academic institutions and United Nations agencies from all continents, based on the expertise of climatologists, engineers, economists, political scientists, public health professionals, and doctors. Every year, Lancet Countdown publishes an annual assessment of the state of climate change and human health, seeking to provide decision makers with access to high-quality evidence-based policy guidelines. As well as a policy recommendation in selected countries on the impact of climate change locally. This translation addresses the Brazilian political recommendation. 

A Revista Brasileira de Medicina de Família e Comunidade (RBMFC) agradece aos Avaliadores listados abaixo que atuaram como revisores ad hoc durante o ano de 2018, dedicando horas voluntariamente para a emissão de pareceres técnicos sobre manuscritos submetidos a esta revista.

Objective: To understand the extent of the components of the Person-Centered Clinical Method relates to the practice of acupuncture, based on the perception of the users. Methods: By a qualitative research with focus group, this study aimed to understand how acupuncture makes the person to perceive their health and illness experience; intensifies the person’s perception as an integral being; allows for the person to participate in the process of care; strengths the physician-person relationship. Results: The themes that emerged included emancipation, self-knowledge, completeness, bonds and affections. They were organized in categories: Integrated MCCP/MTC practice producing rhizomes; Mind-body unity in the context of care; Perception of an emotional anatomy and MCCP and MTC reconfiguring the Circuit of Affections. Conclusions: The study reflects, from the perception of the users, the use of the knowledge that derives from other rationalities to enhance the care performed in Primary Health Care.

Introduction: While there are, internationally, several evidence-based online summaries most are English-language, paid or internationally restricted. Thus, we are developing an online evidence-based point-of-care summary, in Portuguese, free of charge, transparent and free of pharmaceutical industry inputs. Methods: We selected 28 topics for the first phase of the project. These topics comprise problems that cover 50% of the demand in primary care, are developed under the methodology of rapid reviews, and are peer reviewed. We conduct the search for evidence in a discretionary manner, giving preference to systematic reviews. The authors, who have no conflicts of interests, fund the website. The content of the site is under Creative Commons BY-NC-SA license. Results: We created a manual for the development of the topics and the website www.condutas.com.br is available for access with three topics developed: resfriado comum (common cold), hipertensão arterial (hypertension) and pré-natal (antenatal care). Conclusion: The Condutas em Atenção Primária has editorial quality and adequate evidence-based methodology, compared to other online summaries, which is an advance for the Brazilian clinical practice. Its innovative profile democratizes access to current, consistent and diverse information previously restricted to the English-language reader, yet, at the same time, it faces the limitations of its pioneering and inherent amateurism.