Acesso e utilização dos serviços na Estratégia Saúde da Família na perspectiva dos gestores, profissionais e usuários Access to and use of the services of the family health strategy from the perspective of managers, professionals and users

Questionnaires adapted to the Brazil- ian reality (Primary Care Assessment Tool) to evaluate access to and use of services were distrib- uted to 30 managers, 80 professionals and a ran- dom sample of 882 Family Health Strategy (FHS) users in Sao Luis in the state of Maranhao. The differences between the evaluations of managers, professionals and users were identified by the Kruskal-Wallis test and Dunn's post test. Users faced difficulties in access to and use of the services, which were also considered unsatisfactory by man- agers and professionals. Access was the dimension with the worst evaluation, and non-functioning of units after 6 p.m. and at weekends were the main difficulties. The evaluations of the managers and professionals were almost always divergent from those of the users, with the evaluation of the managers being more favorable. The fact that the service was free of charge, the use of preventive services and the FHS services before the special- ized care were well evaluated. The operation of units should attend users' needs, especially that of the working population. Strengthening social par- ticipation in local management of the FHS may assist in identifying these needs, thereby reducing the divergent opinions of the players involved. 1