Abstract
The study aimed to create a meta-evaluation model for Primary Health Care applied in the External Evaluation of Access and Quality Improvement Program and discuss lessons learned in the process. We conducted a qualitative study in Natal/RN (Brazil) between August 2018 and March 2020. Literature review included quality standards from the Joint Committee Standards for Education Evaluation for Public Health Programs: A Self-Study Guide and examination of Access and Quality Improvement Program Instructional Manual. Steps for developing the study were elaboration, agreement, validation, and consultation with stakeholders. Results showed changes in political context from favorable to restrictive; consistency with metaevaluative assumptions and qualitative research; agreement between meta-evaluators, managers, and evaluators of universities participating in the program; and validation by experts. Stakeholders indicated the following for meta-evaluation: development of manuals, permanent education, workshops, seminars, online forums, and creation of a meta-evaluation network. In conclusion, the model is coherent with meta-evaluation of External Evaluation of PMAQ-AB, useful, and applicable to other evaluative contexts of Primary Health Care, including post-COVID-19.