Theme: 
Good practices and lessons learned with the implementation of PMM
Scope: 
Municipal. Municipalities of Cururupu, Presidente Sarney, Santa Helena, São João Batista and Satubinha. State of Maranhão.
Analysis Unit: 
Coverage, access in regions with high social vulnerability and large population pockets in extreme poverty, and a lack of health care.
Major results: 
1. The PHC model and the Family Health Care Strategy is efficient when it has all professionals present at the health units. 2. The Program fulfilled its role by reducing the immediate lack of doctors in locations with a difficult access. 3. The improvement in access to doctor visits increased the demand for a greater investment and planning in Primary Health Care. 4. PMM has firmly reduced the lack of doctors and is a great promoter of permanent instruction as a structural component of the Program. 5. Initially, language was a major concern, as it represents a communication barrier. However, the professional position of the Cuban doctors and the quality of their health care demystified this bias.
Implementing Unit: 
PAHO/WHO, Researchers
Methodology: 
This case study involved an exploratory, descriptive type of research with a qualitative coverage. Data collection through observation visits, focus groups, interviews, and analysis of work action plans upon TCC course completion.
Recommendations / Challenges: 
1. It is a challenge for educational institutions to train health professionals, especially doctors capable of caring for the health needs of a population. 2. The guidance provided by TCC (action plans) should have been more dynamic when directing or specializing for feasible goals during the expected intervention period, in order to observe the results.
Summary: 
On the basis of health care priorities established by the Government of Maranhão, the case study research team travelled through five small municipalities in two neighboring meso-regions for the purpose of replicating the good practices and lessons learned with the implementation of PMM in the Primary Health Care.