Evaluation by Community Health Agents of the attributes of Primary Health Care for fighting leprosy

Abstract

Objective: To evaluate whether the attributes of Primary Healthcare are present in leprosy control actions in Londrina from Community Health Workers (CHW) perspectives. Methods: Observational and evaluative study. Data collection took place between January and March 2020 in Londrina, Paraná, using the questionnaire "Primary Care Assessment Tool (PCATool) - Hansen's disease - CHW version" and a population-based census of 246 CHWs from 52 Primary Healthcare Units. The analyses used a cutoff point (≥ 6.6), central tendency, and dispersion measures. One-way ANOVA and Tukey's post hoc tests were used to analyze differences. Results: The general performance towards the primary healthcare attributes were evaluated as strong (mean = 6.95 / SD = 1.08) and the essential score (mean = 7.39 / SD = 1.0). On the other hand, the derived score was evaluated as poor (mean = 6.07 / sd = 1.06). Concerning the Access attribute, the rural zone had a lower score than the urban (mean = 4.47 / SD = 1.63). As for the Comprehensiveness attribute of services provided to leprosy patients, the central region had a lower mean (mean = 4.87 / SD = 3.44) than the south region (mean = 6.76 / SD = 2, 24). Concerning the Integrality, the rural region presented a higher score (mean = 8.15 / SD = 1.22) than the western (mean = 6.16 / SD = 2.91) and central regions (mean = 6.13 / SD = 3.27). As for Community Orientation, the western region had a lower mean than the others (mean = 5.04 / SD = 2.44). The vocational guidance attribute had a higher average in the rural region (mean = 4.14 / SD = 2.62). Final Considerations: The study highlights issues that can be improved, such as first contact access, catalog of services offered to leprosy patients, information provided to the community, professional training, and differences in PHC performance between urban and rural regions.