The COVID-19 pandemic intensified the preexisting downward trend in the number of primary health care services performed in Brazil. Between 2019 and 2022, there was a 42.5% decrease in screenings, 28.9% reduction in diagnoses and 41.2% drop in medical consultations. These are among the findings of a study by researchers Adriano Massuda, Alessandro Bigoni, Marco Antonio Paschoalotto and Renato Tasca at the Center for Health Planning and Management Studies (FGVsaúde), part of the Sao Paulo School of Business Administration (FGV EAESP), which was published in GV-Executive in June 2022.

According to the authors, in order to restore the public health system’s resilience, primary care services need to become more accessible to the public. Among other things, the study calls for increased federal government funding and the participation of state governments in the distribution of resources. The researchers also argue that a strategy to support human resources is necessary, including attractive pay and working conditions, as well as adequate infrastructure and technology for teams to perform diagnostic tests and procedures as part of primary health care.

“The COVID-19 pandemic highlighted the role of primary care in the resilience of health systems at global level. The exponential growth of severe cases of the disease led to the collapse of even health systems with good hospital infrastructure,” the authors stressed. Previous studies mentioned by the authors found that primary care has had positive effects in terms of reducing inequalities in mortality between racial groups, for example.

On the other hand, the study points out, staff reduction and resource transfer policies were accentuated by Congress’ decision in 2016 to freeze the federal government’s overall spending in real terms for 20 years. Because of the lack of federal coordination in the response to COVID-19, municipal governments incurred expenses to keep services running and this increased regional inequalities, as municipalities had to resort to internal sources of financing.

“In the fight against COVID-19, the federal government relegated the role of primary health care to the background, even though Family Health Strategy teams have long played an important role in controlling communicable diseases. Contact tracing and treatment are routine activities for these teams when dealing with cases of tuberculosis and meningitis, for example. The combination of epidemiological analysis and direct contact with the population has made the Brazilian health system more resilient when dealing with epidemics such as H1N1, dengue and zika virus,” the authors emphasize.

You can see the complete study here.