Results of primary health care intervention for prevention of hospitalizations and mortality due to hypertension in Brazil, 2000–2015

  • Marislei NishijimaEmail author
  • Flavia Mori Sarti
  • Adriana Schor
Original Article



The article studies the effects of widening population access to primary health care related to hypertension indicators, taking advantage of a program led by the central government, based on community agent visits to households, adopted by the Brazilian decentralized municipalities (the Family Health Strategy).

Subjects and methods

Data on annual observations of 5560 municipalities (2000–2015) were used to estimate ordinary least square, fixed effect and quantile regression models to account for specific local differences and differences in levels of the program coverage.


Our estimates indicate that access to a primary health system positively affects hypertension morbidity and mortality indicators, and program effects were higher in non-poor municipalities, possibly because of differences in governance and infrastructure at the local level.


Access to primary health care in developing countries has additional benefits than the reduction in mortality rates due to primary and secondary prevention, such as the benefits spillovers to non-communicable chronic diseases. However, lack of resources, socioeconomic inequalities, and deficiencies in primary health care operationalization in poor regions may limit the effect of primary health care programs.


Primary health care Hypertension Public health system Prevention Universal health coverage 



The authors would like to thank the Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazilian National Council for Scientific and Technologic Development, CNPq) for granting productivity scholarship.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of International RelationsUniversity of Sao PauloSao PauloBrazil
  2. 2.School of Arts, Sciences and HumanitiesUniversity of Sao PauloSao PauloBrazil

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