Quotes of informants illustrate thematic categories. Omitted words or sentences are indicated by ellipsis in brackets [...].
Information Technology use to disseminate AE/PMAQ-AB results
Technology was essential to disseminate results, especially for information transparency and ease of its use, as highlighted below:
[...] data systematization and publicity obtained clearly and objectively during the third cycle to facilitate and optimize use of data. From this perspective, the goal is always to move forward, seeking new consulting tools for the produced information. [...] systems, microdata, individualized reports per state, municipality, and team can be performed by accessing the e-Gestor and DAB/MS portal (D1).
According to the interviewer, despite the mechanism of dissemination of results, advancements regarding accessibility are needed due to difficulty in using the produced information.
[...] we need advances in methods even more accessible for managers and health workers, for permanent use of results in action plans to improve what is being performed (I2).
Despite the use of technology, dissemination of results to interested parties at an opportune time is still challenging due to difficulties regarding investment, reduced technical team, and large number of variables in the instrument, according to DAB/MS:
We are trying to solve problems that hinder availability of results at an opportune time. Investments in technology and professionals are difficult. We lack a stronger IT development group to make these data available; lack of sufficient technical team; the instrument has many variables, making its validation difficult (FG-DAB).
Online reports in information disclosure process
The main purpose of reports was data and information sharing, mainly for managers and their teams, to contribute to action plans for PHC. According to the quote below, reports are available in a system developed by the demandant.
It is possible to access analytical and descriptive reports in the e-Gestor system, an important tool offered by the Ministry of Health for workers and managers to reflect some evaluated aspects of PMAQ. [...] promoting its use in local and municipal planning and resetting processes regarding work of teams and management to strengthen PHC (D2).
Technology use enabled availability of analytical reports to public access. These reports show data analysis from AE/PMAQ-AB and some recommendations to improve team performance.
Analytical reports are public documents available at the Primary Care Department/PMAQ/e-Gestor that consist of external evaluation analysis and suggestions to improve team performance (D3).
The main objective of this report is to provide analytical elements to support discussion and reflection of results and improve important services.
[...] to support primary care managers and teams in reflecting their work process and organization of health service access, from welcoming to spontaneous demand and team schedules. [...] may support discussion and reflection to improve these services (D3).
For DAB/MS, these reports present accessible data organization and availability, with pleasant navigability for interested parties.
[...]analytical reports have more pleasant interface and navigability, all with public access; any person can have access. [...] This improvement is attributed to qualification of the instrument and data, not to mention that tablets are better programmed (FG-DAB).
Despite the effort to structure reports with interface of easy access, managers and health teams still experience difficulties:
[...] analytical reports are great; the problem is that people cannot read information contained in the reports. Therefore, we have a problem because the municipality takes that report and does not know what to do with it [...] (I5).
Only managers have access to descriptive reports, and authentication with login and password is needed for information regarding PMAQ-AB team certification. Results show the possibility to follow team performance.
Descriptive reports are public access documents available at the portal of Primary Care Department/PMAQ/e-Gestor that contains PMAQ results by team, municipality, and state. Indexes are presented and compared in these reports, and teams receive certification in the first and second cycles of the program (in previous cycles) (D2).
Limited access of the manager to descriptive reports was mentioned as limitation to dissemination of results since information was restricted and used according to interest of the manager. DAB/MS considers data openness could increase usage:
Descriptive reports are under login and password of the manager, which is less interested in discussing these results. Maybe with public access, direct access without bureaucracy for teams, use of reports would have been greater (FG-DAB).
DAB/MS considers that methods for disclosing results are preliminary; however, it recognizes efforts to improve reports and contribute with its use by managers and teams.
[...] I think our methods for disclosing results are still very preliminary; we have few reports, we improve in each cycle, but we are far from offering reports to contribute with use of results by manager and team workers for practical changes [...] (I-DAB).
Portraits of Primary Health Care as open data strategy
Portraits of Primary Health Care are considered another channel to disseminate results, compiling public results from all variables of AE/PMAQ-AB:
[...]Portraits of Primary Health Care is a collection of questions, a panorama that anyone can access. [...] to use information that makes sense. From this point of view, I think that DAB/MS favored dissemination of results (FG6).
AE/PMAQ-AB data in the Portraits of Primary Health Care platform is stored, available, and disclosed for all national territories.
Primary care portrayal provides information of more than 42,000 health teams of 5,324 municipalities of the third PMAQ-AB cycle. Data from 13,775 Family Health teams, 25,090 Family Health teams with Oral Health, 4,110 Expanded Centers of Family Health and Primary Care, and 30,346 Family Health Unities are available (D4).
Main resources available from Portraits of Primary Health Care provide data utility and produce information to be used by interested parties.
Appropriation of results of the third PMAQ-AB cycle and use and transformation of data into useful information in both primary care monitoring and management processes for teams and managers are one of the main goals of the proposed system (D4).
Organization for data access is performed by different methods, depending on objectives of interested parties.
Data can be accessed in four ways: by thematic, which provides variables grouped by theme and it is possible to reach the lowest level of disaggregation that are questions from the questionnaire; access by variables that compose the questionnaire; certification access, which provides information regarding performance of evaluated teams; and the last access is crossing variables, which crosses data from PMAQ external evaluation (D4).
As described above, thematic access allows simplified navigation of the instrument; access using variables can be performed individually or together by crossing variables of the instrument. Performance of evaluated teams can be verified using certification access.
Database access in virtual environment
Public access to AE/PMAQ-AB microdata (database) (Ministry of Health website) was another channel used for disseminating results. The virtual environment to access microdata comprises six modules, and data sheets related to each module can be downloaded according to geographic area (Brazil, State, and City). This sheet contains evaluated data and a dictionary to explain terms and codifications used for results (D5).
Despite the concern about data organization and availability, work with dataset is complex and may hinder the production of information for knowledge use:
[...] it is complex to transform those data into information. [...] I think that translation those data in a way that people can use in practice is challenging (I7).
Moreover, DAB/MS reaffirms the difficulty in using and understanding the available microdata.
[...] I question if our way of providing data facilitates its use and understanding. Microdata is difficult to use. We know that managers do not use all data, and we have not facilitated this use (FG-DAB).