Measuring the quality of primary care in national health surveys: Lessons from Brazil

Erno Harzheim, Luiz F. Pinto, Otávio P. D'Avila, Lisiane Hauser
African Journal of Primary Health Care & Family Medicine | Vol 12, No 1 | a2251 | DOI: | © 2020 Erno Harzheim, Luiz Felipe Pinto, Otávio P. D’Avila, Lisiane Hauser | This work is licensed under CC Attribution 4.0
Submitted: 21 September 2019 | Published: 29 January 2020

About the author(s)

Erno Harzheim, Medicine School, Federal University of Rio Grande do Sul, Porto Alegre (UFRGS), Brazil
Luiz F. Pinto, Department of Medicine in Primary Health Care, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
Otávio P. D'Avila, Dentistry School, Federal University of Pelotas (UFPel), Rio Grande do Sul, Porto Alegre, Brazil
Lisiane Hauser, Brazilian Health Ministry Consultant, Rio Grande do Sul, Porto Alegre, Brazil


Background: South Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until then the only one that had never used it in evaluation of primary health care facilities until 2015.

Aim: The authors aim to demonstrate that after the consolidation of Bresick’s team to an African version of PCAT, it had been adapted to household survey in Brazil.

Methods: In this letter, authors reflect on how Brazil had adapted PCAT to a national random household survey with Brazilian National Institute of Geography and Statistics (IBGE) – the Brazilian Census Bureau.

Results: In the the beginning of 2019, Brazilian Ministry of Health brought back the PCAT as the official national primary health care assessment tool. Brazilian National Institute of Geography and Statistics (IBGE) included a new module (set of questions) in its National Health Survey (PNS-2019) and collected more than 100 000 households interviews in about 40% of the country’s municipalities. This module had 25 questions of the Brazilian validated version of the adult reduced PCAT.

Conclusion: We believe that IBGE innovation with the Ministry of Health can encourage South Africa to establish a similar partnership with its National Institute of Statistics (Statistics South Africa) for the country to establish a baseline for future planning of primary health care, for decision-making based on scientific evidence.


Africa; Brazil; primary health care; evaluation; PCAT


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