Supporting a rapid primary care response to emergent communicable disease threats with PACK (Practical Approach to Care Kit) in Florianópolis, Brazil
Emerging infectious diseases present a significant challenge to healthcare systems with their need for a rapid response and reallocation of resources. This paper explores the implementation of the Practical Approach to Care Kit (PACK) programme in Florianópolis, Brazil as a strategic tool for reinforcing primary healthcare (PHC) responses to emergent communicable diseases. With its focus on enhancing PHC delivery in resource-limited settings, PACK provides a flexible, evidence-based framework that integrates into local health systems. The paper describes experiences adapting PACK to provide rapid responses to outbreaks of Zika, leishmaniasis, COVID-19, Mpox and dengue in primary care between 2014 and 2023. Key features of PACK, including its flexibility to incorporate new clinical content, responsive implementation strategy and health system strengthening approach, are highlighted. The paper emphasises how PACK supported responses to specific disease outbreaks and helped maintain mainstream PHC delivery, preventing the system from becoming condition-centric during crises. We describe the limitations of the PACK approach in an outbreak scenario, the challenges experienced and efforts to tackle these. The lessons learnt from Florianópolis underscore the adaptability and relevance of comprehensive primary care approaches like PACK in supporting PHC professionals and local health systems to navigate emerging health challenges.
Authors
- João Paulo Mello da Silveira (ORCID: https://orcid.org/0000-0003-3816-0299)
- Ruth Cornick (ORCID: https://orcid.org/0000-0002-7391-3383)
- Ana Cristina Magalhães Fernandes Báfica (ORCID: https://orcid.org/0000-0001-5158-3427)
- Ronaldo Zonta (ORCID: https://orcid.org/0000-0003-0576-4774)
- Jorge Zepeda (ORCID: https://orcid.org/0000-0002-3279-0372)
- Pearl Wendy Spiller (ORCID: https://orcid.org/0009-0007-2687-6018)
- Christy‐Joy Ras (ORCID: https://orcid.org/0000-0003-2001-172X)
- Matheus Pacheco de Andrade (ORCID: https://orcid.org/0000-0002-3184-5634)
- Filipe de Barros Perini (ORCID: https://orcid.org/0000-0001-8139-2031)
- Elizimara Ferreira Siqueira (ORCID: https://orcid.org/0000-0002-9526-9939)
- Lara Fairall (ORCID: https://orcid.org/0000-0002-7460-4670)
- Daniella Georgeu-Pepper (ORCID: https://orcid.org/0000-0003-2745-7820)
- Ajibola Awotiwon (ORCID: https://orcid.org/0000-0003-0887-8670)
- Camilla Wattrus (ORCID: https://orcid.org/0000-0002-2075-7903)
- F Pinto (ORCID: https://orcid.org/0000-0002-6104-5910)
- Mariela Zaros Galana (ORCID: https://orcid.org/0009-0008-8370-7306)
- Bernardo Manata Eloi (ORCID: https://orcid.org/0009-0005-2136-9442)
Institutions
- University of Cape Town (ZA)
- Universidade do Estado de Santa Catarina (BR)
- King's College London (GB)
- City of Bradford Metropolitan District Council (GB)
- Knowledge Integration (United Kingdom) (GB)
- Secretaria Municipal de Saúde (BR)
Publication Details
- Journal
- BMJ Global Health
- Published
- 2024-10-01
- DOI
- https://doi.org/10.1136/bmjgh-2023-013815
- Citations
- 7
- Primary Topic
- Mosquito-borne diseases and control
- Type
- article
- Field-Weighted Citation Impact
- 3.80
Funders
- U.S. President’s Emergency Plan for AIDS Relief
- Government of the United Kingdom
- Escola Nacional de Saúde Pública Sérgio Arouca
- National Institute for Health and Care Research
- Department of Health and Social Care
- Fundação Oswaldo Cruz
- University of Cape Town
- Peter Sowerby Foundation
- Centers for Disease Control and Prevention
- School of Public Health and Family Medicine, University of Cape Town