Evaluation of primary child health care in Brazil: a systematic review of methods and results

This systematic review analyzes the methods and instruments employed to evaluate primary child health care in Brazil and their main findings. The review was conducted in accordance with the recommendations of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) statement. Searches of articles focusing on children aged between zero and five years published between 1994-2006 were conducted of thefollowing databases: MEDLINE, LILACS, IBECS, BDENF, PubMed, PsycNET, Cochrane, and CINAHL. The searches yielded 3,004 articles. After initial screening and the application of the STROBE and SRQR criteria, 21 articles were included in the review. About 52% of the articles were conducted in the Southeast region and 95.2% were published as of 2010. The most commonly used evaluation tool was the Primary Care Assessment Tool Child Edition, adapted and validated for use in Brazil (52.4%). The quality of primary child care was inadequate. The main limitations included poor access to services, inadequate facilities, and underqualified health staff. There has been a significant increase in the number of evaluation studies conducted in Brazil in recent years. Despite advances in health care across the country, the findings point to the need for a more effective response to the challenges in ensuring comprehensive primary child care in Brazil.