Availability and readiness assessment of Family Health Units of the Southern Axis of Paraguay for the care of people with arterial hypertension and diabetes in 2022

Abstract

Paraguay set out to achieve universal coverage and access through networks based on Primary Health Care with Family Health Units (FHU). One challenge is to address non-communicable diseases, which cause premature mortality in the country. The objective of the study was to evaluate the capacity of the FHU to provide care to people with arterial hypertension and diabetes. The design was observational, descriptive, cross-sectional with an analytical component. It included 172 FHU from the four Sanitary Regions that make up the Southern Axis. The WHO SARA evaluation method was adapted with 75 tracer indicators, applying a questionnaire addressed to health professionals between November and December 2022. Availability and preparation synthesis rates were calculated, which were measured from 0 to 1. The median of the availability index was 0.71, the readiness index 0.76, and the SARA USF-DM/HTA index 0.74. The availability of medicines was the main gap followed by basic equipment for neuro examination, communication equipment and the Internet. In readiness, activities like supervision, evaluation, as well as case management in the service network resulted in lower performance. Only 44.2% of the FHUs had sufficient readiness and availability performance. Rural FHUs performed worse than urban ones. There was a significant difference between the health regions p<0,001. In conclusion, the FHUs presented limitations for diabetes and arterial hypertension patient care in these regions of the country.