The Perceived quality assessment of the health services offered to riverine communities in Brazilian Amazon




ServQual, Sustainability Indicators, Health Services Evaluation, Decision making


In line with the UN Agenda 2030 Sustainable Development Goals, Public Health Policies follow in Brazil criteria of universality, completeness, and equity formulated to ensure access to health services in adequate quantity and quality for the entire population. To evaluate the quality of services provided in health units, it is essential, however, to make methodological considerations to concern the use of proper instruments and techniques to achieve accuracy and precision regarding their effectiveness for the user population. Mainly where health care is precarious or in need of adjustment, properly constructed indicators can become excellent management tools. This paper aims to analyze the specificities of the perception of the quality of health services offered to residents of the riverside communities of the Tupé Sustainable Development Reserve (SDR), Manaus, Amazonas, Brazil. The methodological approach is from a descriptive and ecological case study, based on field research with original data collection of fixed residents, aged over 18 years, by applying structured questionnaires and analyzing the results according to the SERVQUAL methodology. In the present study, it observed the impact of previous experiences of attending on the quality of health service. In the case of SDR of Tupé, there were positive evaluations with above 70% in all items. Still, when analyzing the data set and cut, considering the existence or not of previous experience, a different pattern of perception was detected. Based on these results, we suggest that the quality perception of health has to do with competitiveness, associated with the performance standard on the offer available to the customer.


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Author Biographies

Pedro Henrique Mariosa, Federal University of Amazonas

Research and Professor at Environment and Culture Institute

Orandi Mina Falsarella, Pontifical Catholic University of Campinas (PUC-Campinas)

Research and Professor at Pontifical Catholic University of Campinas (PUC-Campinas) Center for Economy and Administration, Sustainability Postgraduate Program Brazil.

Renato Ribeiro Nogueira Ferraz, Mogi das Cruzes University (UMC) - Mogi das Cruzes, SP.

Graduate Program in Public Policy (PPG-PP) at Mogi das Cruzes University (UMC) - Mogi das Cruzes, SP.

Henrique dos Santos Pereira, Federal University of Amazonas

Research and Professor at Graduate Program of Environmental Sciences and Sustainability of Amazon; Agrarian Sciences College.


Berkman, LF, Kawachi, I., & Glymour, MM (2014). Social epidemiology. Oxford University Press.

Bovaird, T. (2015). Public management and governance (3 d). Routledge.

Castro, F. de, Lopes, G. R., & Brondizio, E. S. (2020). The Brazilian Amazon in Times of COVID-19: From crisis to transformation? Ambiente & Sociedade, 23, e0123.

Daspett, Mendonça, F., Soares Rocha, S., Pimenta Pinheiro, D. L., & Vilges de Oliveira, S. (2020). Região Norte do Brasil e a pandemia de COVID-19: Análise socioeconômica e epidemiológica. Journal Health NPEPS, 5(1), 20–37.

Fachin, O. (2006). Fundamentals of methodology. Sao Paulo (SP): Saraiva.

Fares, R. C. G., Souza, K. P. R., Añez, G., & Rios, M. (2015). Epidemiological Scenario of Dengue in Brazil. BioMed Research International, 2015, 1–13.

Fadel, MAV, & Regis Filho, GI (2009). Quality perception in public health services: a case study. Journal of Public Administration, 43 (1), 7–22.

Feather, MM, Silva, EMS of, Tronchin, DMR, & Melleiro, MM (2013). The use of the quality model of Parasuraman, Zeithaml and Berry in health services. Journal of the USP School of Nursing, 47 (5), 1227–1232.

Ferreira, M. U., & Castro, M. C. (2016). Challenges for malaria elimination in Brazil. Malaria Journal, 15(1), 284.

Freitas, ALP (2005). Quality in services in the context of competitiveness. Online Production Magazine, 5 (1), 1–24.

Garvin, DA (2002). Managing quality the strategic and competitive vision. Rio de Janeiro: Qualitymark.

Gianesi, IGN, & Correa, HL (1994). Strategic service administration: operations for customer satisfaction. Sao Paulo: Atlas.

Gonçalves, HM, & Sousa, CP de. (2015). Articulations between social representations and subjectivity: a study of national production between 2000 and 2010. Revista Educação e Contemporânea, 12 (27), 258–288.

Hair, JF (Org.). (2006). Multivariate data analysis (6th ed). Upper Saddle River, NJ: Pearson Prentice Hall.

Helman, C. (2007). Culture, health, and illness (5th ed). Hodder Arnold; Distributed in the U.S.A. by Oxford University Press.

Jannuzzi, P. de M. (2016). Monitoring and Evaluation of Social Programs: an introduction to concepts and techniques. Campinas - SP: Line.

Medeiros, FA, Araújo-Souza, GC, Albuquerque-Barbosa, AA, and C. Clara C., I. (2010). Reception in a Basic Health Unit: the user satisfaction in focus. Rev public health, 12 (3), 402–413.

Mitra, A. (2016). Fundamentals of quality control and improvement (Fourth edition). Hoboken, New Jersey: Wiley.

Mujica-Mota, RE, Roberts, M., Abel, G., Elliott, M., Lyratzopoulos, G., Roland, M., & Campbell, J. (2015). Common patterns of morbidity and multi-morbidity and their impact on health-related quality of life: evidence from a national survey. Quality of Life Research, 24 (4), 909–918.

Paim, J., Travassos, C., Almeida, C., Bahia, L., & Macinko, J. (2011). The Brazilian health system: history, advances, and challenges. The Lancet, 377 (9779), 1778–1797.

Parasuraman, A., Zeithaml, VA, & Berry, L. (1985). A Conceptual Model of Quality Service and Its Implications for Future Research. Journal of Marketing, 49 (4), 41–50.

Parasuraman, A., Zeithaml, VA, & Berry, LL (1988). Servqual: A Multiple-Item Scale For Measuring Consumer Perc. Journal of Retailing, 64 (1), 12.

Pena, M. M., Silva, E. M. S. da, Tronchin, D. M. R., & Melleiro, M. M. (2013). The use of the quality model of Parasuraman, Zeithaml and Berry in health services. Revista Da Escola de Enfermagem Da USP, 47(5), 1227–1232.

Pereira, JCR (2001). Qualitative data analysis: methodological strategies for health, human and social sciences. Sao Paulo: EDUSP: FAPESP.

Pereira, JCR (2004). Qualitative data analysis: methodological strategies for health, human and social sciences. Campinas: Edusp.

Pinto, R. C., Castro, D. B. de, Albuquerque, B. C. de, Sampaio, V. de S., Passos, R. A. dos, Costa, C. F. da, Sadahiro, M., & Braga, J. U. (2016). Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil. PLOS ONE, 11(8), e0161884.

Santos, FB dos, Marques, LAM, & Duarte, HG (2011). Fundamental Rights: the search for its realization. Legal Framework, Rio Grande, XIV, (92).

Serra, NOR (2002). AT THE WATER Rhythm AT THE WATER Rhythm. Magazine Presence for Education, Culture and the Environment, VI (24), 13.

Tanaka, OY, & Tamaki, EM (2012). The role of evaluation for decision making in health service management. Science & Collective Health, 17 (4), 821–828.

United Nations. (2015). Transforming our world: the 2030 agenda for sustainable development. Rio de Janeiro: United Nations in Brazil. Retrieved from



DOI: 10.31686/ijier.vol8.iss11.2759

How to Cite

Mariosa, D., Mariosa, P., Falsarella, O., Ferraz, R., & Pereira, H. (2020). The Perceived quality assessment of the health services offered to riverine communities in Brazilian Amazon. International Journal for Innovation Education and Research, 8(11), 360–374.
Received 2020-10-09
Accepted 2020-10-23
Published 2020-11-01