Brazil
Strengthening Nursing Roles and Nursing Education in Developing Countries
We evaluated the auxiliary-based primary care health system initiated in the northeast state of Ceara, which has since gone on to become a national model for Family Medicine, Health Agents, and a key role for nurses as supervisors, managers, and primary care providers. The system was built on a small set of actions that health aides provided, monthly, to every home. Staff were selected, trained, and supervised by nurses who spent half time as administrators, half time as clinic-based clinicians. It became a very popular, low cost program that was associated with one of the most rapid reductions in child mortality anywhere in the world. The more comprehensive family medicine model in Brazil builds on this nurse-run community health system.
Publications
Cuffino E, Garfield R, Vasconcelos I, Craviero V. Primary Health Care Lessons from Northeast Brazil. Nursing Leadership Forum 1996; 2(4): 126-31.
Svitoni E, Garfield R, Vasconcelos I. Primary health care lessons from northeast Brazil. Bulletin of the Pan American Health Organization 2000; 7(5): 293-301.
Links
Secretaria da Saúde e Ação Social (http://www.sobral.ce.gov.br/sec/saude/index.html)