Multiprofessional care and the development of the Singular Therapeutic Project within the scope of Primary Health Care in Brazil, 2014–2023

Multiprofessional care in Primary Health Care (PHC) is characterized by the application of interdisciplinary and humanized technologies. Among these, the Singular Therapeutic Project (STP) stands out, consisting of the development of personalized care plans based on the biopsychosocial context of service users. PHC is structured by teams dedicated to preparing such plans, particularly the Multiprofessional Teams (eMulti). These teams represent the Ministry of Health’s renewed focus on comprehensive and multidisciplinary care in PHC in 2023, as well as the continuation of the work carried out by the Family Health Support Center teams (NASF), whose federal co-financing was discontinued in 2019. In this context, this study aimed to describe, in a ten-year historical series, the meetings held for the preparation of STP by NASF and eMulti teams. A descriptive quantitative study was conducted using secondary data on meetings held for the preparation of STP by these teams between 2014 and 2023 in Brazil. Data were extracted from the public online Collective Activities platform of the Primary Health Care Information System (Sisab). From 2014 to 2023, a total of 423,793 meetings were held for the purpose of developing STP by NASF and eMulti teams in PHC. The year 2019 stood out with the highest percentage of meetings (18.84%, n=79,862) carried out by NASF, compared to the other years in the period, including 2023, the year in which eMulti teams were implemented. Between 2019 and 2023, there was a 50.19% decline in this activity. When stratifying the data by macro-region, a predominance of meetings was observed in the Southeast (44.08%, n=186,803), followed by the Northeast (29.38%, n=124,505). The South (14.97%, n=63,463), Center-West (6.48%, n=27,466), and North (5.09%, n=21,556) regions showed lower percentages of records. Moreover, all regions of the country presented a decline in meetings for the preparation of STP from 2019 onwards. The highest number of meetings was held by NASF teams in 2019, followed by a decline in subsequent years, can be attributed to the discontinuation of federal co-financing for these teams, as well as to the emergence of the COVID-19 pandemic in 2020. The Southeast and Northeast regions concentrated the largest number of activity records: the former stands out for its demographic size and team implementation, while the latter holds historical prominence in the implementation of NASF in its municipalities. In contrast, the North region presented the lowest frequency of meetings for STP preparation, which may be explained by challenges related to regional mobility, professional retention, and difficulties in ensuring adequate human resources. Among the limitations of this study, it is important to note the impossibility of identifying the professional categories and intersectoral actors who participated in the meetings. Furthermore, in Sisab, it is not possible to distinguish between NASF and eMulti outputs from 2023 onward, since the system considers both as the same type of team. Despite these limitations, the results indicate the need to monitor these activities to ensure the continued incorporation of STP into multiprofessional work processes in PHC.