Spatial structure of primary health care provision in Brazilian municipalities

Abstract

This article highlights the role of geographical distance in the provision of Primary Health Care (PHC) services in Brazil, considering the provision of PHC units and health care professionals in Brazilian municipalities. To identify the coverage of PHC services in Brazilian municipalities, methods of exploratory spatial data analysis, assessment of the balance between potential supply and demand, and linear programming models were used in order to identify census sectors that concentrate covered and uncovered population. The results show that 6% of Brazilian municipalities have less than 50% of the population covered, while some municipalities have more teams than would potentially be necessary. In the intra-municipal analysis, the results of a study in a Brazilian capital - Belo Horizonte (MG) - point out locations where health teams may not be distributed in an equitable manner. Results show that, in general, that even in face of the recent improvement in regional distribution of doctors it is still possible to identify lack of provision of PHC in some locations. The adoption of government provision actions can contribute to the reduction of these regional disparities.

Keywords:
Health Service Coverage; Primary Health Care; Regional Distribution; Equity in Health