Modelos de atenção primária à saúde da criança: análise comparada

• Ano de defesa: 2016
• Autor(a) principal: Santos, Nathanielly Cristina Carvalho de Brito
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal da Paraíba; Brasil; Enfermagem; Programa de Pós-Graduação em Enfermagem; UFPB
• Palavras-chave em Português: Atenção Primária à Saúde; Saúde da criança; Avaliação de Serviços de Saúde; Primary Health Care; Child´s health; Health Service Evaluation; Atención Primaria a la Salud; Salud del Niño; Evaluación de Servicios de Salud; CIENCIAS DA SAUDE::ENFERMAGEM
• Link de acesso: https://repositorio.ufpb.br/jspui/handle/tede/8705

In the world, a significant number of children still die, before celebrating the fifth birthday, from preventable causes in qualified primary care. Therefore, health care models should be oriented to Primary Health Care and / or structured in accordance with its ordering attributes. Objective: To compare the degree of orientation to the child´s primary health care in basic care units which operate with different models of care. Method: It is a cross-sectional, quantitative and evaluative research in which a total of 1,484 family members and / or caregivers of children under ten years took part. These children were seen in health units which work with different models of care. Data collection was carried out from October 2012 to February 2013 by using the instruments: Primary Care Assessment Tool, Brazil, child version, to evaluate the Primary Care; and the other one covering the families´ socio-demographic and economic data. The analysis was made by means of descriptive statistics with simple frequencies and construction of scores of evaluated attributes, according to the Ministry of Health Manual. To evaluate the most oriented model to Primary Health Care and compare the attributes among the different models, the parametric analysis of variance - associated with Tukey´s multiple comparison test -, and Kruskal-Wallis test - associated with Dunnett´s multiple comparison test - were applied, respectively, both with a 5% significance level. Results: By comparing the models, statistically significant difference was verified in favor of the mixed Basic Health Unit model (p<0,05) to the overall score and superiority to the essential score, even without significant difference. As to the attributes, only the first contact access - use - was satisfactory and did not show any difference between the models. However, among the attributes that showed differences, this was favorable to the mixed model for degree of affiliation, coordination - integration of care, comprehensiveness – available services and provided services, and to the traditional Basic Health Unit model for the dimensions: information system and accessibility. Although the derived attributes have not reached the cut-off point, the models that work with the Family Health Strategy had a favorable difference for family and community orientation. Conclusion: The mixed Basic Health Unit was revealed as the most oriented model to the child´s primary care. This is possibly due to the sum of potentialities of the traditional and the Family Health Strategy models, once even with limitations, they showed overall scores close to ideal. Thus, when integrated into a single structure, they can contribute to improving the work process of the teams towards the reorientation of the child´s primary care.