The Line of Care Protocol for Primary Care NCDs contributes to the organization of the work of early detection and tracking of risk situations by professionals at Basic Health Units. Care is everyone’s responsibility, the citizen, family, community, educational sectors, public and private, but health professionals help through the planning, execution and evaluation of longitudinal care in which the Basic Unit is the gateway. Within the scope of this protocol, Active Search, Tracking, Campaigns, and Home Visits actions are carried out. Through them, it is possible to survey complaints, measure high blood pressure, rapid tests, and others in search of warning signs and symptoms, and perform tracking for CNCDs. Values above expectations must be confirmed and referred for diagnosis. Whenever necessary, the citizen is referred for care by the health unit team.
Non Communicable Chronic Diseases Care Line
Official Name of Signatory
Delegation
Brazil
Website of the Signatory
Name of the person presenting the Good Practice
Lucas Roberto Paredes Santos
Position/Job Title of person presenting the Good Practice
Assessor International Relations
Aim of the Good Practice
It creates a protocol for early detection and tracking of citizens who have Chronic Noncommunicable Diseases, helping families in the planning, execution and evaluation of longitudinal care in which the Basic Unit is the “gateway”
Target Group of the Good Practice
Citizens who attend a Basic Health Unit
Implementation period
Continuous action carried out in Basic Health Units
Consistency over time
Continuous action carried out in Basic Health Units
Evaluation of the Good Practice
Activities are carried out directly by professionals in the units, so there is no monitoring of the application of the Line of Care Protocol. However, the office monitors the implementation of campaigns, training and also diagnostic indicators for these CNCDs , using SUS management instruments, such as the Annual Management Report.
Key stakeholders and partnerships
Actions are implemented in partnership with the Regional Health Coordinations and the health establishments that help publicize them