Quality Assessment in Primary Health Care Services: An Integrative Literature Review

Abstract

Quality assessment in primary health care is essential to strengthen Brazil’s Unified Health System (SUS) and guide the reorganization of services, ensuring access, comprehensiveness, and equity. This study aimed to analyze the main approaches, challenges, and potentialities of quality assessment in primary care through an integrative literature review. Searches were conducted in the SciELO, PubMed, LILACS, and Google Scholar databases using descriptors related to “assessment,” “quality,”
“primary care,” and “SUS,” including studies published between 2015 and 2025 in Portuguese, English, and Spanish. After screening 727 identified studies, 13 were included in the analysis. The results highlighted the diversity of instruments and frameworks available, with a predominance of process and structural indicators, but pointed out weaknesses such as low integration of results into service planning, regional inequalities, and limited participation of professionals and users in evaluation processes. National studies emphasized the need for team engagement and the strengthening of participatory
practices, while international research stressed the standardization of indicators and the adaptation of strategies to local contexts. It is concluded that evaluation should transcend its bureaucratic character, becoming a political, participatory, and critical practice capable of supporting decision-making and promoting continuous improvements in primary health care.