The first module of the “More Data Better Health” study on Primary Health Care (PHC) pointed out that among the reasons are overcrowding and wait time, bureaucracy of referrals, self-medication and a belief that the problem is not serious
The data comes from a study conducted by Vital Strategies and Umane, with technical partnership from the Federal University of Pelotas (UFPel) and support from Instituto Devive and Resolve to Save Lives
São Paulo, April 25, 2025 – A brand new survey interviewed Brazilians from all over the country, aged 18 years or more, and found that 62.3% of the population needed medical care in Primary Health Care (PHC) in the last year and did not seek medical attention. These data are part of the first module of the More Data Better Health study series, a program of innovation in health data collection, carried out by Vital Strategies and Umane, with technical partnership from the Federal University of Pelotas (UFPel) and support from Instituto Devive and Resolve to Save Lives, which evaluated the population’s perception of access to and quality of PHC, the gateway to the public and private healthcare systems.
Respondents could point to more than one reason for not seeking care, even when in need of it, whether in SUS or in the private network. Among the reasons, overcrowding and wait time, pointed out by 46.9%, followed by bureaucracy in referral (39.2%), the practice of self-medication (35.1%) and the belief that the issue was not serious (34.6%), among others, were the most prominent. The data were collected between August and September 2024 in interviews with 2,458 Brazilian users of both the private and public healthcare systems (the latter being the Unified Health System – SUS).
“More Data Better Health comes as a continuation of the partnership between Umane and Vital Strategies in conducting population surveys with themes relevant to public health, such as Covitel, carried out in 2022 and 2023”, says Thais Junqueira, general superintendent of Umane. “In this first module, we innovate by performing data collection exclusively online. The methodology proved to be reliable and agile, and this is an important step to optimize public health research. We hope that new questionnaires can be applied at shorter time intervals”, adds the general superintendent of Umane.
The results show that the overload of the Brazilian healthcare system, either public or private, can lead to the abandonment of the search for medical care, reinforcing the need for more investments and improvements in the management of services to optimize the supply and reduce wait times. In addition, the survey allows us to interpret that there is a widespread cultural habit of treating health problems without professional assistance, especially those that should be treated in Primary Health Care (PHC), which can lead to inappropriate use of medications, postponement of effective treatments and even worsening of conditions, which would have simpler treatments if diagnosed earlier.
The research also showed that 40.5% of respondents sought medical help in the last 12 months and were unable to receive care. The obstacles identified were long wait times (62.1%), lack of equipment (34.4%), lack of adequate professionals (30.5%) and lack of care (29%), among others.
“As a gateway to SUS and in its role as coordinator of care, Primary Health Care must be organized in such a way as to ensure that most of the population’s health issues are preventable and treatable, without evolving into more complex conditions. Strengthening these mechanisms so that the population seeks timely care when necessary and receives the care they need is fundamental to have a more efficient and resolute health system”, concludes Thais Junqueira.
Quality of care
The study also evaluated the perception of users in relation to the last visit with a health professional or in a usual care unit, both in the public and private systems. For this, respondents could evaluate each item as terrible, bad, regular and very good. Of the eight items evaluated, six had more positive responses. The main highlight was the respect for privacy and confidentiality, rated as regular or very good by 79.2% of respondents, followed by a positive evaluation by 75,1% of respondents for the understanding of the explanations provided.
“Trust in the professional spoken to” received a positive evaluation from 67.8% of the population, while 64.4% praised the opportunity to question or raise concerns. Of the respondents, 59.8% rated their participation in care/treatment decisions positively and 56.3% rated the duration of the consultation positively.
On the other hand, wait time for care was rated negatively by 57.6% of respondents and ease of referral received complaints from 51.5% of the population.
“These findings suggest that, although most users of the public and private healthcare systems report positive experiences in their visits, important and structural challenges persist that hinder the access to and quality of Primary Health Care. Improvements are needed to ensure continuous investments and enhancement of services to promote greater equity in the healthcare of the population”, says Luciana Sardinha, Deputy Director of Noncommunicable Diseases at Vital Strategies Brazil.
Innovative methodology
The “More Data Better Health” survey stands out both for its new data and for its innovative methodology: it was carried out entirely online, with recruitment through internet ads. This approach ensured agility, low cost and collection with a sampling of all Brazilian adults in just 14 days, creating a replicable model for future research, including on emergency topics such as epidemics or natural disasters.
“This new methodology, in addition to aligning Brazilian and other international practices that are underway, will be fundamental for the analysis of relevant public health issues in a shorter span of time, such as in cases of epidemics, offering valuable inputs for decision-making and the creation and strengthening of public policies”, says Pedro de Paula, country director of Vital Strategies Brazil, national office of the global health organization.
The sample, of 2,458 people from all regions of the country, was made nationally representative based on variables from the 2022 Census (region, sex, age and race/color), adjusted for schooling according to the 2019 PNS. The “Yellow” and “Indigenous” racial categories used in the Census were excluded from the analyses due to the small number of participants. The questions elaborated in this module consist of an adaptation to the Brazilian reality of a questionnaire that is being validated by global organizations and coordinated by Resolve to Save Lives. Brazil is one of the countries piloting the application of the questionnaire with the aim of supporting the improvement of a PHC access assessment scale that can be applied globally.
About More Data Better Health
More Data Better Health is a program of innovation in health data collection, carried out by Vital Strategies and Umane, with technical partnership from UFPel and support from Instituto Devive and Resolve to Save Lives. The initiative seeks to strengthen more equitable and effective public policies through the generation of data that support decision-making in public administration. It focuses on testing effective data collection methodologies and monitoring emerging or underexplored themes in health.
The More Data Better Health survey is available in full at Umane’s Public Health Observatory, through this link: www.observatoriosaudepublica.com.br/pesquisas/mais-dados-mais-saude/
About Vital Strategies
Vital Strategies is a global health organization that believes all people should be protected by effective and equitable health policies and systems. Our team works with governments and civil society to design and implement evidence-based strategies and policies to address some of the world’s greatest public health challenges. The result is millions of people living longer, healthier lives.
About UMANE
Umane is an independent, non-profit civil society organization that supports initiatives in the field of Public Health with the aim of contributing to a more resolute Unified Health System (SUS) and improving the quality of life of people living in Brazil. In 2024, Umane supported 33 projects carried out in collaboration with 89 partners, among various sectors of health, civil society and government.
Umane operates through three programs: Comprehensive Care for Chronic Noncommunicable Diseases (NCDs), with initiatives for controlling risk factors, screening, expanding access to healthcare and monitoring risk factors in Primary Health Care; Strengthening Primary Health Care (PHC) as a coordinator of care in SUS, through support for initiatives aimed at operational improvements, team productivity, integration of services and the incorporation of new technologies to the healthcare system; and the Women’s, Children’s and Adolescent Health program, funding programs that follow and monitor unfavorable outcomes during pregnancy and the health conditions of children and adolescents in the context of Chronic Noncommunicable Diseases and risk factors. Follow Umane on social media: LinkedIn and Instagram.
More information
Analítica Comunicação – “Mais Dados Mais Saúde” (mais.saude@analitica.inf.br)
Gabriela Scheinberg – gabi.scheinberg@analitica.inf.br – (11) 91096-4944
Raíza Dias – raiza.dias@analitica.inf.br – (11) 95272-3944
Mauricio Espósito – mauricio.esposito@analitica.inf.br – (11) 99915-7583
Erica Benute – erica.benute@analitica.inf.br – (11) 99185-7078