Elsevier

Public Health

Volume 147, June 2017, Pages 47-50
Public Health

Short Communication
Assessing the potential effectiveness of oral health promotion strategies in primary health care in Brazil

https://doi.org/10.1016/j.puhe.2017.01.028Get rights and content

Highlights

  • Our results showed significant differences in oral heath promotion amongst distinct Brazilian regions.

  • The highest scores were seen in the richest Southeastern and Southern regions where health promotion strategies were followed.

  • The lowest scores were seen in the Central-Western and Northern regions, which are much poorer regions.

  • These findings indicate that promoting equity through our National health policies is important to provide equal access to health for everyone.

Introduction

Tackling the social determinants of diseases in primary health care by promoting health, better quality of life, and disease prevention defines the so called ‘New Public Health’ movement in Brazil.1, 2 The Brazilian Unified Health Care System, forged on this movement, aims to guarantee the right to health to all individuals adopting the principles of universality, equity, integrality, decentralization, and regionalization of health services under social control, with primary health care as their main strategy.3

The Brazilian primary care,3 health promotion,4 and oral health5 policies aim at ensuring a holistic health care network by providing social initiatives and intervening on risk factors with strategic programmatic actions.3, 4, 5 Based on this approach and following international health promotion initiatives, oral health teams aim to develop actions on health promotion, disease prevention, diagnosis, treatment, monitoring, rehabilitation, and health maintenance for everyone.3, 4, 5 Oral health promotion strategies must be developed based on health promotion pillars and values, combining a common risk factors approach and focusing on the social determinants of health/disease.6, 7 Therefore, the potential effectiveness of oral health promotion strategies depends on the extent to which they include these pillars and values regarding planning, implementation and sustainability of actions.

Regardless of increasing numbers of oral health teams working in primary health care in Brazil through the expansion of the Brazilian family health strategy, evidence concerning the effectiveness of primary health care and oral health promotion strategies remains unclear.8 The main goal of this research was to determine the effectiveness of oral health promotion strategies developed by professionals in primary health care, which were mapped by the Brazilian National Study of Health Promotion Practices (Estudo Nacional de Práticas de Promoção da Saúde – ENPROSA), conducted by the Brazilian Center for Surveillance on Oral Health/Ministry of Health.

Section snippets

Applying the oral health promotion evaluation toll

The secondary database of the ENPROSA was used in this study, which encompassed oral health promotion strategies that were developed in primary health care in 26 Brazilian State capitals and the Federal District. Information was obtained from a sample of 1819 dental surgeons (75.3% female and 24.7% male) of a total population of 2069 professionals working for at least one year in primary health care services at Basic Health Units.

To collect the data in each city during the ENPROSA, dental

Oral health promotion in primary health care

The mean score obtained by the analyzed oral health promotion strategies developed in primary health care was 71.3 (95% confidence interval [95% CI] 70.4–72.1; P ≤ 0.42). Moreover, the majority (54.9%) of the evaluated strategies were not in alignment with the health promotion pillars and values, having little potential for promoting oral health.

The final scores showed great variability among the 26 Brazilian capitals and the Federal District, suggesting an important role of the geographical,

Ethical approval

The Research Ethics Committee at the Pontifical Catholic University of Paraná in Curitiba (PR) approved this study. Informed consent was obtained from each participant in accordance with the Declaration of Helsinki.

Funding

The National Health Fund from the Ministry of Health in Brazil funded this study. The sponsors had no involvement in the study design, data collection or write up.

Competing interests

None declared.

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There are more references available in the full text version of this article.

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