Trends and Geographical Distribution of Family Health Strategy in Brazil from 2009-2023

Area of Science:

• Public Health
• Health Policy
• Health Services Research

Background:

• The Brazilian Unified Health System (SUS) operates on principles of universality, equity, and integrality.
• The Family Health Strategy (FHS), established in 1994, is a key policy to strengthen universal healthcare in Brazil.
• FHS was fully incorporated nationwide in 2006, aiming to improve primary healthcare delivery.

Purpose of the Study:

• To analyze temporal trends in FHS coverage across Brazil and its states from 2008 to 2023.
• To investigate the correlation between FHS coverage and the Human Development Index (HDI) at the state level.
• To identify regional disparities and patterns in FHS expansion over time.

Main Methods:

• Time series analysis using Prais-Winsten regression was performed on FHS team and population data from the Brazilian Ministry of Health.
• Annual Percentage Change (APC) was calculated to describe time trends in FHS coverage.
• Linear regression models were employed to assess the relationship between HDI and FHS coverage across Brazilian states.

Main Results:

• National FHS coverage rose from 66.81% in 2009 to 84.66% in 2023.
• Significant regional disparities in coverage persisted, with the Northeast region showing high coverage but lower growth rates.
• A negative correlation was observed between HDI and FHS coverage, indicating FHS expansion in areas with lower development indicators.

Conclusions:

• FHS coverage has demonstrably increased across Brazil, with notable achievements in the North and Northeast regions.
• Nine federative units reached and maintained 100% FHS coverage, predominantly in the North and Northeast.
• The negative correlation between FHS and HDI suggests the strategy effectively targets and serves vulnerable populations.