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The Programa Saúde da Família (PSF), Family Health Program, in Portuguese language is one of the national public health programs in Brazil, which implements a national policy for primary care settings with the aim of substituting part of the traditional model of primary care based on medical specialists. As its name says, its main focus is on families instead of individuals, and it is organized around multidisciplinary Family Health Teams, formed by a core of professionals such as physicians, nurses, dentists, psychologists and social workers, as well as community health agents, a kind of "barefoot doctor". Brazil has currently (August 2009) approximately 30,000 of these teams, deployed in 5,241 of its 5,656 municipalities.〔(DATASUS Statistical Data of Health in Brazil )〕 The population coverage by PSF is 96.1% (a total of more than 141 million inhabitants). A total of 5,339 municipalities have 230,000 community health agents.〔(Statistics of Family Health Program. Ministry of Health, August 2009 )〕 PSF is now considered one of the main strategies of universal health care, service reorganization and reorientation of professional practice at this level of care, as well as a platform for health promotion, disease prevention and rehabilitation. Annual federal investments in the Program amount to ca. 2.5 billion US dollars. ==History== PSF as a concept originated in 1991, as a part of the reform of the health care sector demanded by the new Constitution of Brazil, with its intent of increasing the accessibility of health to all, and to enhance the actions of prevention and health promotion. In that year, PACS, a program for training and deploying of community health agents was started. After many theoretical discussions and preparations, the program was launched by the Ministry of Health in 1994, as part of the so-called Sistema Único de Saúde (SUS), or ''Unified Health Care System'', the most ambitious initiative of the Brazilian federal government to establish a hierarchically-organized and rationally funded program of public health, which is responsible for providing care to 75% of Brazil's current population of approximately 190 million inhabitants. The Program expanded rapidly and, in 2006. recognizing its importance, the federal government issued the Decree No. 648 of March 28, 2006, where it was established that PSF was going to be a strategic priority of the Ministry of Health to organize primary care in the country, and the main tool to enable universal and continuing access to health services under the basic principles of SUS: universality, equity, decentralization, comprehensiveness, and community participation. The unique identification and central registry of all citizens of the country, using a so-called SUS Card, was to be one of its main organization supports. In its most recent development, a program for establishing in each region a Family Health Support Nucleus (NASF: Núcleo de Apoio à Saúde da Família) was started by the federal government in cooperation with state and municipal governments, In addition, a system of SUS Schools (training schools in several cities and states) was established, in order to provide the buildup and training of the huge specialized workforce required by SUS and PSF. The initial training of community health agents is part of its mission. PSF has, so far, produced a positive impact on the direction of this new model of health care and prevention, but it still has not been able to completely substitute the former model, based in an overvaluation of the practices of curative care, medical specialists and hospitals, with its emphasis on an excess of technological procedures and drugs, leading to high costs. This traditional model has resulted in an undesired fragmentation of care. PSF strives to offer integrated health care focused on the family, instead of individuals, but the penetration of the model is still incomplete in most of the cities. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Programa Saúde da Família」の詳細全文を読む スポンサード リンク
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