Nationwide population-based household surveys in health: a narrative review. / Inquéritos domiciliares nacionais de base populacional em saúde: uma revisão narrativa.

Household surveys are one of the primary methodologies used in population-based studies. This narrative review of the literature aims to gather and describe the leading national and international household surveys of relevance. In Brazil, the historical role played by the Brazilian Institute of Geography and Statistics (IBGE) in conducting the most relevant research in the production of social data stands out. The Medical-Health Care Survey (AMS) and the National Household Sample Survey (PNAD), with the serial publication of Health Supplements, are the country's primary sources of health information. In 2013, in partnership with the Ministry of Health, IBGE launched the National Health Survey (PNS), the most significant household health survey ever conducted in Brazil. The PNS-2019 received a major thematic and sampling expansion and, for the first time, applied the Primary Care Assessment Tool to assess PHC services in all 27 Brazilian states.

Os inquéritos domiciliares representam uma das principais metodologias empregadas em estudos de base populacional. O objetivo desta revisão narrativa da literatura é reunir e descrever os principais inquéritos domiciliares em saúde de relevância nacional e internacional. No Brasil, destaca-se o papel histórico desempenhado pelo Instituto Brasileiro de Geografia e Estatística (IBGE) na condução das pesquisas mais importantes na produção de dados sociais. A Pesquisa de Assistência Médico-Sanitária (AMS) e a Pesquisa Nacional por Amostra de Domicílios (PNAD), com a publicação episódica de Suplementos Saúde, consistem das principais fontes de informação em saúde no país. Em 2013, o IBGE, em convênio com o Ministério da Saúde, lançou a Pesquisa Nacional de Saúde (PNS), o maior inquérito domiciliar em saúde já realizado no Brasil. A PNS-2019 recebeu uma grande ampliação, tanto temática, quanto ao tamanho de sua amostra, e, pela primeira vez, aplicou o instrumento Primary Care Assessment Tool para avaliação dos serviços de Atenção Primária em Saúde em todas as unidades da federação do Brasil.

Inquéritos domiciliares nacionais de base populacional em saúde: uma revisão narrativa / Nationwide population-based household surveys in health: a narrative review

Resumo Os inquéritos domiciliares representam uma das principais metodologias empregadas em estudos de base populacional. O objetivo desta revisão narrativa da literatura é reunir e descrever os principais inquéritos domiciliares em saúde de relevância nacional e internacional. No Brasil, destaca-se o papel histórico desempenhado pelo Instituto Brasileiro de Geografia e Estatística (IBGE) na condução das pesquisas mais importantes na produção de dados sociais. A Pesquisa de Assistência Médico-Sanitária (AMS) e a Pesquisa Nacional por Amostra de Domicílios (PNAD), com a publicação episódica de Suplementos Saúde, consistem das principais fontes de informação em saúde no país. Em 2013, o IBGE, em convênio com o Ministério da Saúde, lançou a Pesquisa Nacional de Saúde (PNS), o maior inquérito domiciliar em saúde já realizado no Brasil. A PNS-2019 recebeu uma grande ampliação, tanto temática, quanto ao tamanho de sua amostra, e, pela primeira vez, aplicou o instrumento Primary Care Assessment Tool para avaliação dos serviços de Atenção Primária em Saúde em todas as unidades da federação do Brasil.

Abstract Household surveys are one of the primary methodologies used in population-based studies. This narrative review of the literature aims to gather and describe the leading national and international household surveys of relevance. In Brazil, the historical role played by the Brazilian Institute of Geography and Statistics (IBGE) in conducting the most relevant research in the production of social data stands out. The Medical-Health Care Survey (AMS) and the National Household Sample Survey (PNAD), with the serial publication of Health Supplements, are the country's primary sources of health information. In 2013, in partnership with the Ministry of Health, IBGE launched the National Health Survey (PNS), the most significant household health survey ever conducted in Brazil. The PNS-2019 received a major thematic and sampling expansion and, for the first time, applied the Primary Care Assessment Tool to assess PHC services in all 27 Brazilian states.

Primary Care Assessment Tool (PCAT): developing a new baseline for evaluating Brazilian health services. / Primary Care Asssement Tool (PCAT): a construção de uma nova linha de base para avaliação dos serviços de saúde no Brasil.

In Brazil, within the SUS, Primary Health Care (PHC) gained relevance from the Family Health Strategy's structuring from the 1990s to the 2000s. Several instruments are available in the world to evaluate PHC services, including the family of instruments of the Primary Care Assessment Tool (PCAT), developed and disseminated by Starfield & Shi to assess the existence and extent of the features of primary health care services. Reinforcing the importance of using this instrument in Brazil, the Ministry of Health published in 2020 a new edition of the Brazilian version that informs the methodology used for such instruments, reviving the role of IBGE as a significant external evaluator of the SUS. The IBGE pioneered in its primary household random sample survey, the National Health Survey, a question-based module of the reduced version of the PCAT for adult users. The leading global results found for Brazil (overall PCAT score=5.9) inform that those who use PHC services (adults with referred morbidities) the most are also those who evaluate these services most positively. Differences were also observed among the residents of households registered by the family health teams, those receiving visits from the community and endemic workers, and age groups (older people evaluate services more positively).

No Brasil, no âmbito do SUS, a APS ganhou relevância a partir da estruturação da Estratégia Saúde da Família entre as décadas de 1990/2000. Existem inúmeros instrumentos para a avaliação desses serviços no mundo. Dentre eles, destaca-se a família de instrumentos do Primary Care Assessment Tool (PCAT), desenvolvida e disseminada por Starfield e Shi para avaliar a existência e extensão das características dos serviços de atenção primária em saúde. Reforçando a importância do uso desse instrumento no Brasil, o Ministério da Saúde publicou em 2020, uma nova edição da versão brasileira que informa a metodologia utilizada, resgatando o papel do IBGE como grande avaliador externo do SUS. O IBGE incluiu de forma pioneira em seu principal inquérito amostral domiciliar, a Pesquisa Nacional de Saúde, um módulo de perguntas da versão reduzida do PCAT para usuários adultos. Os principais resultados globais encontrados (escore geral=5,9) informam que aqueles que mais utilizam os serviços de APS (adultos com morbidades referidas), são também os que avaliam mais positivamente tais serviços. Também foram observadas diferenças entre os moradores de domicílios cadastrados pelas equipes de Saúde da Família, entre os que recebem visitas de agentes comunitários e agentes de endemias e, por faixa etária (os mais idosos avaliam de forma mais positiva os serviços).

Accompanimeter 1.0: creation and initial field testing of a tool to assess the extent to which the principles and building blocks of accompaniment are present in community health worker programs.

Background: The strategic incorporation of community health workers (CHWs) into health system strengthening efforts is recognized as a critical and high-value approach for meeting the Sustainable Development Goals established by the United Nations in 2015. How to best build CHW programs, however, is prone to a wide variety of opinions and philosophies, many of which are often externally imposed. Partners in Health (PIH) is a non-governmental organization that pioneered an approach to healthcare system strengthening, called accompaniment, in which CHWs play a key role. Learning from PIH is a critical first step in replicating the organization's achievements beyond PIH. As such, PIH has developed a tool, referred to as the 'Accompanimeter 1.0,' that serves to evaluate existing CHW programs and guide adjustments in programming.Objective: To provide a standardized approach for defining, assessing, and implementing accompaniment in CHW programs using a tool called the Accompanimeter 1.0.Methods: Development of this tool included three stages: (1) desk review of literature relevant to the work of CHWs globally, (2) discussions among colleagues and initial field testing, (3) feedback from colleagues who are experts in community health and in the principles of accompaniment.Results: Three core principles of accompaniment in a CHW program were identified: professionalization, CHWs as bridges to institutional strength, and community proximity. These core principles direct five thematic areas that are found in successful CHW programs: Partnering (co-creating engagement with a continuous and intersectoral dialogue to improve the program); Choosing (identifying the right people for the right job); Educating (building CHWs´ capacity); Incentivizing (enabling CHWs to perform their work without financial sacrifice); Supervising (mentoring CHWs for personal growth).Conclusions: The Accompanimeter 1.0 can serve as a helpful tool for CHW program implementation and policy decisions that maximize system-side inputs, community engagement, and support for individuals with medical issues.