Author / Partners: 
PAHO/WHO and UFRGS
Theme: 
Quality and Effectiveness of PHC services
Scope: 
National
Analysis Unit: 
PMM Cuban and Brazilian doctor service users that are part of the Family Health Strategy (6,160 users). PMM Cuban doctors (8,235 Cuban doctors)
Methodology: 
Cross-sectional study with application of the PCATool-Brazil reduced version applied to users and Cuban doctors.
Results / Conclusions: 
Cuban doctors prevail in the health care of the most vulnerable strata. The general Primary Health Care score for the More Doctors Cuban group (6.86) is higher than the national average, showing a performance trend higher than that of Brazilian groups (6.74) and Family Health Strategy groups (6.73). The country’s access to health care was low (4.24), with a statistical difference between groups. The More Doctors Cuban group had the highest score (4.43), and Brazilian groups (4.08) and (4.20). Longitudinality scored high (7.43), without a significant difference between the groups, with a trend of a higher index in the ESF group (7.48), as compared to the More Doctors Brazil (7.43) and More Doctors Cuba (7.38) groups. Same-day appointments by Cuban doctors rated 51.8%, Brazilian doctors (41.38%) and Family Health Strategy doctors (46.7%).
Recommendations / Lessons Learned: 
There is a need to identify other factors that hinder access in view of its low score throughout the country. The organization of the Primary Health Care doctor appointment schedules must be reconsidered to enable it to handle the spontaneous demand during critical situations. The use of information and communication technology needs to be expanded. There is also the need to reorganize the teams’ working process with an emphasis on the subsidiarity in the doctor and nursing clinical work, as well as in the health promotion and disease prevention tasks by other team professionals. There was an improvement in the structure of health care units.
Status: 
Completed