Health services accessibility in a city of Northeast Brazil

In order to analyze the implementation of measures targeting accessibility to primary health care in a municipality (county) in the State of Bahia, Brazil, a single case study was performed with two levels of analysis: system and services organization. The data were obtained from semi-structured interviews, observation of routine care, and document analysis. Of the four health units analyzed, three showed intermediate-level implementation of measures targeting accessibility. The Family Health Units showed better performance, due to measures for patient reception and referral to specialized services, but they revealed problems with scheduling of appointments. Despite having defined primary care as the portal of entry into the system and the implementation of a help desk for setting appointments with specialists, there are persistent organizational barriers in the municipality. A specific policy is recommended to improve accessibility, aimed at organization of the services supply in order to change the health care model.