Qualidade do seguimento da saúde da criança prematura em serviços de atenção primária de municípios da faixa de fronteira do Paraná

• Ano de defesa: 2025
• Autor(a) principal: Alderete, Geisyelli
• Orientador(a): Silva, Rosane Meire Munhak da
• Banca de defesa: Arcoverde, Marcos Augusto Moraes , Mello, Débora Falleiros de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual do Oeste do Paraná; Foz do Iguaçu
• Programa de Pós-Graduação: Programa de Pós-Graduação em Saúde Pública em Região de Fronteira
• Departamento: Centro de Educação Letras e Saúde
• País: Brasil
• Palavras-chave em Português: Atenção primária à saúde; Recém-nascido prematuro; Continuidade da assistência ao paciente; Qualidade da assistência à saúde; Saúde na fronteira
• Palavras-chave em Inglês: Primary health care; Premature infant; Continuity of fatient care; Quality of health care; Border health
• Palavras-chave em Espanhol: Atención primaria de salud; Recién nacido prematuro; Continuidad de la atención al paciente; Calidad de la atención de salud; Salud fronteriza
• Área do conhecimento CNPq: ENFERMAGEM::ENFERMAGEM DE SAUDE PUBLICA
• Link de acesso: https://tede.unioeste.br/handle/tede/7905

Introduction: prematurity is a major global public health issue, as it represents the leading cause of death among children under five years of age. It is closely linked to poor-quality care during the prenatal period, at birth, and throughout ongoing health monitoring. The quality of care depends on a range of factors, including professional practice, the organization of healthcare across different levels, and the active involvement of the family. Objective: to analyze the quality of follow-up care in Primary Health Care (PHC) for premature infants in the western border region of Paraná State, from the perspective of nurses. Methods: a quantitative, analytical, and exploratory study conducted in primary health services in municipalities located along the western border of Paraná. The study population comprised 264 nurses from 71 municipalities. Data were collected both in person and remotely using the Google Forms® platform, based on the “Qualiprematuro” guide, structured into five domains: hospital discharge planning and care plan organization; home visits and telehealth follow-up; child health monitoring to promote health and prevent complications; integration among health, education, and specialized services; and family support for caregiving. Data were analyzed using Jamovi software version 2.3.28 and adjusted chi-square tests (X²). Results: hospital discharge was rated as inadequate (61.7%); home follow-up and telehealth (49.2%), child health monitoring (58.0%), and inter-service integration (60.2%) were considered fair; while family support was rated as good (56.7%). Weaknesses were identified in outpatient return, home visits, protocols, staff training, telehealth, waiting lists, behavioral and psychomotor assessments, community integration, health education, parental guidance, counter-referral, intersectoral coordination, and lack of psychological support for parents. Positive aspects included timely care, access to services, the Popular Pharmacy Program, medical transportation, and nutritional supplementation. Differences across health regions, municipality size, and urban/rural characteristics revealed statistically significant disparities (p<0.05). Conclusion: strategic actions such as strengthening intersectoral support, developing specific guidelines for premature infant follow-up, implementing continuing education initiatives for professionals, improving nursing care, and designing public policies tailored to the unique conditions of border municipalities could enhance the role of primary care as the cornerstone of follow-up. This study aims to contribute to future research and interventions that support the effectiveness of care for premature infants, ensuring not only their survival but also improvements in quality of life and developmental outcomes.