# Comparative analysis of primary health care attributes between children under and over 3 years of age using the primary care assessment tool

## TL;DR

This study compares primary health care quality for children under and over 3 years in Brazil, finding better care for younger children and suggesting new programs for older ones.

## Contribution

The study identifies specific gaps in primary health care for children beyond early childhood using a comparative analysis.

## Key findings

- Children under 3 years had higher scores in primary care attributes like affiliation and longitudinality.
- Caregivers reported better overall and essential scores for younger children in Primary Health Care Units.
- The study highlights the need for improved programs for children over 3 years with rising chronic disease risks.

## Abstract

•Government programs primarily focus on early childhood.•Primary Care services tend to be better for children under three years old.•New programs are needed to provide follow-up care for children beyond early childhood.

Government programs primarily focus on early childhood.

Primary Care services tend to be better for children under three years old.

New programs are needed to provide follow-up care for children beyond early childhood.

Child health actions in Brazil have their primary focus on early childhood. A new epidemiological profile is emerging for children after the first one thousand days: an increase in non-communicable chronic diseases. This research aimed to analyze the attributes of Primary Health Care comparatively among different age groups, using three years of age as the cutoff point.

The study design was cross-sectional and conducted in three Primary Health Care Units and three Ambulatory Medical Assistance facilities in the Western Region of São Paulo. The PCA Tool Brazil was used as the assessment instrument.

A total of 311 interviews were conducted with caregivers of children aged 0 to 12 years; 153 children were under three years old, and 158 were three years or older. The attributes that showed statistically significant differences between age groups (< 3 years and > 3 years) were affiliation (4.9 × 3.8), longitudinality (5.7 × 5.2), information system (7.4 × 6.3), and services provided (5.4 × 4.5). Through linear regression analysis, it was observed that there was a trend for better overall and essential scores in the evaluations of the group of children under three years old who attended Primary Health Care Units.

The comparative analysis of Primary Health Care attributes among pediatric age groups revealed a trend towards higher scores, according to caregivers' perceptions, for children under three years old. This study suggests the need for the implementation of programs that can better address the healthcare needs of children beyond early childhood.