O financiamento estadual da Atenção Primária no Rio de Janeiro: caminhos e perspectivas

Abstract

The 2017 National Primary Care Policy highlights the need for tripartite funding for this level of care, however, the participation of states still has little expression and is materialized in specific strategies, while municipalities in the last 30 years have been expanding their spending in health. Faced with the need to overcome difficulties to fund and maintain primary care services in municipalities, some states have been seeking to regulate and improve their participation in tripartite funding. The State Department of Health of Rio de Janeiro (SES-RJ) started its participation in the financing of Primary Health Care (PHC) in 2007 and has been moving forward over the years with several deliberations on tripartite funding. The general objective of the study is to analyze the state role in the co-financing of primary care in the state of Rio de Janeiro from 2007 to 2020, for the qualification and strengthening of health services. This is a qualitative and descriptive exploratory case study with a combination of different research methods, using bibliographic and documentary research and secondary data. We considered the state PHC co-financing programs between 2007 and 2020 and further evaluated the impacts of the current Primary Care Financing Program (PREFAPS). As a result, it was observed that propositions that bring the PREFAPS components present a strong induction of PHC sustainability and strengthening of the Family Health Strategy, in addition to the organization of the work process. However, it must be considered that the induction of service organization through financial transfer may not correspond to the reality and local needs. In order to establish common goals for all participants, it is necessary to reflect on the local and regional reality and the management capacity of the municipalities to achieve the determined goals.