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      O financiamento da Atenção Básica e da Estratégia Saúde da Família no Sistema Único de Saúde Translated title: The financing of the Primary Health Care and Family Health Strategy in the Unified Health System

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          Abstract

          Analisa-se o financiamento do nível da Atenção Básica à saúde, com ênfase na expansão dos recursos alocados para a Estratégia Saúde da Família. A primeira parte detalha o crescimento dos recursos do Ministério da Saúde para a Atenção Básica, particularmente os transferidos mediante o Piso de Atenção Básica Variável, que incorpora os diferentes incentivos financeiros destinados aos municípios que desenvolvem os programas neste nível de atenção. A segunda parte analisa as dificuldades do financiamento tendo em vista a instabilidade dos recursos próprios municipais e também discute algumas sugestões de modificações nos critérios de repasse dos recursos federais transferidos aos municípios.

          Translated abstract

          It analyzes the financing of the Primary Health Care level, with emphasis on the expansion of the allocated resources to the Family Health Strategy. The first part details the growth of the Ministry of Health resources to the primary care, particularly the ones transferred through the Variable Primary Care Wage, which incorporates the different financial incentives headed for municipalities that develop programs in this level of care. The second part analyzes the difficulties of financing bearing in mind the instability of the municipal own resources and it is also discusses some suggestions of changes in the criteria of federal transfer of funds transferred to municipalities.

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          Política nacional de atenção básica

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            Impact of the family health program on infant mortality in Brazilian municipalities.

            We evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. We collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. We performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. We observed a statistically significant negative association between FHP coverage and infant mortality rate. After we controlled for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities.
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              Reducing childhood mortality from diarrhea and lower respiratory tract infections in Brazil.

              To evaluate the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care in Brazil, on mortality of children younger than 5 years, particularly from diarrheal diseases and lower respiratory tract infections. Mortality rates and the extent of FHP coverage from 2000 to 2005 was evaluated from the 2601 (of 5507) Brazilian municipalities with an adequate quality of vital information. A multivariable regression analysis for panel data was conducted by using a negative binomial model with fixed effects, adjusted for relevant demographic and socioeconomic covariates. A statistically significant negative association was observed between FHP coverage levels, classified as none (the reference category), low ( or=30% and or=70%), and all analyzed mortality rates, with a reduction of 4% (95% confidence interval [CI]: 2%-6%), 9% (95% CI: 7%-12%), and 13% (95% CI: 10%-15%), respectively, on mortality rates or children younger than 5. The greatest effect was on postneonatal mortality. Reductions of 31% (95% CI: 20%-40%) and 19% (95% CI: 8%-28%) in mortality rates from diarrheal diseases and lower respiratory infections, respectively, were found in the group of municipalities with the highest FHP coverage. The FHP, one of the largest comprehensive primary health care programs in the world, was effective in reducing overall mortality of children younger than 5, and particularly deaths related to diarrheal diseases and lower respiratory tract infections.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                sdeb
                Saúde em Debate
                Saúde debate
                Centro Brasileiro de Estudos de Saúde (Rio de Janeiro )
                2358-2898
                December 2014
                : 38
                : 103
                : 900-916
                Affiliations
                [1 ] Universidade Estadual de Campinas Brazil
                [2 ] Fundação Getúlio Vargas Brazil
                Article
                S0103-11042014000400900
                10.5935/0103-1104.20140079
                3e30e0b5-f63b-4e5e-b310-747a42275270

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0103-1104&lng=en
                Categories
                HEALTH CARE SCIENCES & SERVICES
                HEALTH POLICY & SERVICES

                Health & Social care,Public health
                Healthcare financing,Primary Health Care,Family Health Strategy,Financiamento da assistência à saúde,Atenção Primária à Saúde,Estratégia Saúde da Família

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