Variations in the Financing of Primary Health Care in Bahia: An analysis of the Previne Brasil Program

Abstract

The Previne Brasil Program was created as a new financing model for Primary Care. It is a mixed method that involves weighted funding, payment for performance and incentives for strategic actions. This study aims to identify and analyze variations in financial transfers in Primary Health Care, imposed by the Previne Brasil Program, in selected municipalities in Bahia. This is a case study with a quantitative approach, divided into three stages: a) selection of three municipalities with the best and three municipalities with the worst averages of the Final Synthetic Indicator, between 2020 and 2022, from each Regional Health Center from Bahia; b) a database was created with the financial transfers of these selected municipalities, between the years 2017 and 2022; c) analysis of financial losses and gains. The results showed that the Previne Brasil Program emerged with difficult operationalization, requiring the publication of flexible ordinances to mitigate its negative effects. In Bahia, municipalities with a smaller population achieved better results in performance indicators and cities with high coverage of the Family Health Strategy expanded their budgets. In short, there was an increase in financial transfers to most municipalities in Bahia, but Previne Brasil was not able to solve the historical problem of underfunding. Therefore, it is necessary to review the Primary Health Care financing program and increase its proportion of resources in relation to medium and high complexity.