This article in The New England Journal of Medicine on Brazil’s family-health strategy may have lessons for U.S. community health efforts, be they of hospitals, physician groups, Federally Qualified Health Centers or free clinics.
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Interdisciplinary healthcare teams are an important part of the system with each team having a physician, a nurse, a nurse assistant and four to six “full-time community health agents.”
“Each agent is assigned to approximately 150 households in a geographically delineated micro-area within the catchment area — usually the same micro-area where the agent lives. Agents visit each household within their micro-area at least once per month, irrespective of need or demand, and collect individual- and household-level data”“{T}heworld can learn some lessons from the Brazilian experience. First, community-based primary care can work if done properly. It requires a solid blueprint, pilot testing and evidence generation, a long-term vision, and sustained financial and political commitments. ….Finally, building a robust primary care system is more than a bureaucratic exercise; in Brazil, it has required long-term social movements and professional commitments.”