COVID-19 in Brazilian cities: Impact of social determinants, coverage and quality of primary health care

Background Brazil, as many other countries, have been heavily affected by COVID-19. This study aimed to analyze the impact of Primary health care and the family health strategy (FHS) coverage, the scores of the National Program for Improving Primary Care Access and Quality (PMAQ), and socioeconomic and social indicators in the number of COVID-19 cases in Brazilian largest cities. Methods This is an ecological study, carried out through the analysis of secondary data on the population of all Brazilian main cities, based on the analysis of a 26-week epidemiological epidemic week series by COVID-19. Statistical analysis was performed using Generalized Linear Models with an Autoregressive work correlation matrix. Results It was shown that greater PHC coverage and greater FHS coverage together with an above average PMAQ score are associated with slower dissemination and lower burden of COVID-19. Conclusion It is evident that cities with less social inequality and restrictions of social protection combined with social development have a milder pandemic scenario. It is necessary to act quickly on these conditions for COVID-19 dissemination by timely actions with high capillarity. Expanding access to PHC and social support strategies for the vulnerable are essential.

Automated summary

The study shows that greater Primary Health Care and Family Health Strategy coverage, along with higher scores in the National Program for Improving Primary Care Access and Quality (PMAQ), are associated with slower dissemination and lower burden of COVID-19. Cities with less social inequality and restrictions of social protection combined with social development have a milder pandemic scenario.