Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 12 de 12
Filter
1.
Rev. saúde pública ; 51: 23, 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-845889

ABSTRACT

ABSTRACT OBJECTIVE The objective of this study is to evaluate the performance of the Tuberculosis Control Program in municipalities of the State of São Paulo. METHODS This is a program evaluation research, with ecological design, which uses three non-hierarchical groups of the municipalities of the State of São Paulo according to their performance in relation to operational indicators. We have selected 195 municipalities with at least five new cases of tuberculosis notified in the Notification System of the State of São Paulo and with 20,000 inhabitants or more in 2010. The multiple correspondence analysis was used to identify the association between the groups of different performances, the epidemiological and demographic characteristics, and the characteristics of the health systems of the municipalities. RESULTS The group with the worst performance showed the highest rates of abandonment (average [avg] = 10.4, standard deviation [sd] = 9.4) and the lowest rates of supervision of Directly Observed Treatment (avg = 6.1, sd = 12.9), and it was associated with low incidence of tuberculosis, high tuberculosis and HIV, small population, high coverage of the Family Health Strategy/Program of Community Health Agents, and being located on the countryside. The group with the best performance presented the highest cure rate (avg = 83.7, sd = 10.5) and the highest rate of cases in Directly Observed Treatment (avg = 83.0, sd = 12.7); the group of regular performance showed regular results for outcome (avg cure = 79.8, sd = 13.2; abandonment avg = 9.5, sd = 8.3) and supervision of the Directly Observed Treatment (avg = 42.8, sd = 18.8). Large population, low coverage of the Family Health Strategy/Program of Community Health Agents, high incidence of tuberculosis and AIDS, and being located on the coast and in metropolitan areas were associated with these groups. CONCLUSIONS The findings highlight the importance of the Directly Observed Treatment in relation to the outcome for treatment and raise reflections on the structural and managerial capacity of municipalities in the implementation of the Tuberculosis Control Program.


RESUMO OBJETIVO Avaliar o desempenho do Programa de Controle da Tuberculose em municípios paulistas. MÉTODOS Pesquisa de avaliação de serviços, com delineamento ecológico, utilizando três agrupamentos não hierárquicos de municípios paulistas de acordo com seu desempenho em relação a indicadores operacionais. Foram selecionadas 195 cidades com no mínimo cinco casos novos de tuberculose notificados no Sistema de Notificação do Estado de São Paulo e 20.000 habitantes ou mais em 2010. A análise de correspondência múltipla foi utilizada para a identificação da associação entre os grupos de distintos desempenhos e as características epidemiológicas, demográficas e de sistemas de saúde dos municípios. RESULTADOS O grupo de pior desempenho apresentou as taxas mais elevadas de abandono (média [md] = 10,4; desvio padrão [dp] = 9,4) e as menores proporções de efetivação de Tratamento Diretamente Observado (md = 6,1; dp = 12,9) e esteve associado à baixa incidência de tuberculose, alta confecção tuberculose e HIV, pequeno porte populacional, alta cobertura de Estratégia Saúde da Família/Programa de Agentes Comunitários em Saúde e localização no interior. O grupo de melhor desempenho apresentou a maior taxa de cura (md = 83,7; dp = 10,5) e a maior proporção de casos em Tratamento Diretamente Observado (md = 83,0; dp = 12,7); enquanto o grupo de desempenho regular mostrou resultados regulares de desfecho (cura: md = 79,8; dp = 13,2; abandono: md = 9,5; dp = 8,3) e de efetivação do Tratamento Diretamente Observado (md = 42,8; dp = 18,8). Grande porte populacional, baixa cobertura de Estratégia Saúde da Família/Programa de Agentes Comunitários em Saúde, alta incidência de tuberculose e aids, e localização no litoral e em áreas metropolitanas estiveram associados com esses grupos. CONCLUSÕES Os achados destacam a importância do Tratamento Diretamente Observado em relação ao desfecho do tratamento e levantam reflexões sobre a capacidade estrutural e gerencial dos municípios na operacionalização do Programa de Controle da Tuberculose.


Subject(s)
Humans , Cities , Government Programs/standards , Tuberculosis/prevention & control , Brazil/epidemiology , Disease Notification , Health Services Research , Incidence , Program Evaluation , Tuberculosis/epidemiology
2.
Rev. saúde pública ; 48(3): 398-405, 06/2014. tab
Article in English | LILACS (Americas) | ID: lil-718640

ABSTRACT

OBJECTIVE To analyze the effectiveness of the Chilean System of Childhood Welfare in transferring benefits to socially vulnerable families. METHODS A cross-sectional study with a sample of 132 families from the Metropolitan Region, Chile, stratified according to degree of social vulnerability, between September 2011 and January 2012. Semi-structured interviews were conducted with mothers of the studied families in public health facilities or their households. The variables studied were family structure, psychosocial risk in the family context and integrated benefits from the welfare system in families that fulfill the necessary requirements for transfer of benefits. Descriptive statistics to measure location and dispersion were calculated. A binary logistic regression, which accounts for the sample size of the study, was carried out. RESULTS The groups were homogenous regarding family size, the presence of biological father in the household, the number of relatives living in the same dwelling, income generation capacity and the rate of dependency and psychosocial risk (p ≥ 0.05). The transfer of benefits was low in all three groups of the sample (≤ 23.0%). The benefit with the best coverage in the system was the Single Family Subsidy, whose transfer was associated with the size of the family, the presence of relatives in the dwelling, the absence of the father in the household, a high rate of dependency and a high income generation capacity (p ≤ 0.10). CONCLUSIONS The effectiveness of benefit transfer was poor, especially in families that were extremely socially vulnerable. Further explanatory studies of benefit transfers to the vulnerable population, of differing intensity and duration, are required in order to reduce health disparities and inequalities. .


OBJETIVO Analizar la efectividad de las transferencias de beneficios del Sistema de Protección Integral de la Infancia a familias de Chile socialmente vulnerables. MÉTODOS Estudio transversal analítico con 132 familias, estratificadas según vulnerabilidad social en la Región Metropolitana, Chile, entre septiembre de 2011 y enero de 2012. Se aplicó entrevista semiestructurada a madres de familias en centros de salud públicos o en sus domicilios. Las variables fueron: estructura familiar, riesgo psicosocial del entorno familiar y beneficios integrados del sistema de protección social requeridos en las familias que cumplían con el requisito de aplicabilidad para la transferencia del beneficio. Se calcularon estadígrafos descriptivos, de posición y dispersión. Fue realizada regresión logística binaria, pertinente por el tamaño de la muestra. RESULTADOS Los grupos fueron homogéneos en cuanto a tamaño de la familia, presencia del progenitor y número de allegados, capacidad generadora de ingresos, tasa de dependencia y riesgo psicosocial (p ≥ 0,05). La transferencia de los beneficios fue baja en los tres grupos (≤ 23,0%). La mejor cobertura estuvo representada por el Subsidio Único Familiar, cuya entrega se relacionó con el tamaño de la familia, la presencia de allegados, progenitor ausente, la alta tasa de dependencia y alta capacidad generadora de ingresos (p ≤ 0,10). CONCLUSIONES La efectividad de entrega de los beneficios fue baja, especialmente en familias de extrema vulnerabilidad social. Nuevos estudios explicativos de formas de transferencia de beneficios deben ser realizados con diferentes niveles de intensidad y tiempos de exposición en poblaciones vulnerables, para disminuir las disparidades y desigualdades en salud. .


Subject(s)
Adult , Child , Female , Humans , Male , Child Welfare , Government Programs/standards , Public Health , Public Policy , Social Support , Vulnerable Populations , Chile , Cross-Sectional Studies , Government Programs/statistics & numerical data , Mothers , Urban Population
4.
Ciênc. saúde coletiva ; 16(3): 1969-1980, mar. 2011. tab
Article in Portuguese | LILACS (Americas) | ID: lil-582495

ABSTRACT

Este estudo analisa a humanização no trabalho no contexto do Programa Saúde da Família, indagando: que papel desempenha a infraestrutura para a construção de um trabalho humanizado no PSF? O processo de trabalho das equipes revela coerência com os princípios da humanização em saúde? Para buscar respostas para estas perguntas foi explorada a percepção de profissionais do PSF sobre o cotidiano do seu trabalho, considerando as condições concretas em que ele se realiza e as relações, práticas e produtos gerados neste processo. Trata-se de um estudo de casos múltiplos de tipo quali-quanti, com primazia do enfoque qualitativo, realizado através de questionários e grupos focais com equipes do PSF em áreas selecionadas. Os resultados indicam que as fragilidades de infraestrutura e o investimento tímido em formação das equipes são fatores que contribuem para a persistência de condições e práticas de trabalho que se distanciam dos princípios da humanização em saúde. Apesar das dificuldades apontadas, as equipes estudadas revelaram, de modo geral, um alto grau de comprometimento com o trabalho que desenvolvem e alta sensibilidade diante das necessidades e problemas da população.


This study analyzes humanization at work in the context of the Family Health Program (FHP), inquiring: what is the role that infrastructure assumes in the construction of humanized work in the FHP? Does the course of staff work reveal coherency with health humanization principles? In order to find out answers to these questions, it was explored the perception of FHP' professionals about their work routine, considering concrete conditions whereby it occurs besides involved relationships, practices and products. It is a multiple case study, both qualitative and quantitative (with primacy of the first approach), developed through questionnaires and focal-groups with FHP' teams of selected areas. The results indicate that infrastructure fragilities and low investment in training of staffs are factors that contribute for the persistence of work conditions and practices that are far away from health humanization principles. Despite of the difficulties, it was evidenced, by the staffs, in general way, great engagement to their work and great sensibility to population needs and problems.


Subject(s)
Humans , Family Health , Government Programs/standards , Humanism , Primary Health Care/standards , Brazil
5.
Clinics ; 66(11): 1943-1948, 2011. ilus, tab
Article in English | LILACS (Americas) | ID: lil-605876

ABSTRACT

OBJECTIVE: A lack of attention has been given to hearing health in primary care in developing countries. A strategy involving low-cost screening tools may fill the current gap in hearing health care provided to children. Therefore, it is necessary to establish and adopt lower-cost procedures that are accessible to underserved areas that lack other physical or human resources that would enable the identification of groups at risk for hearing loss. The aim of this study was to develop and analyze the efficacy of a low-cost screening tool to identify and classify hearing loss in children. METHODS: A total of 214 2-to-10 year-old children participated in this study. The study was conducted by providing a questionnaire to the parents and comparing the answers with the results of a complete audiological assessment. Receiver operating characteristic (ROC) curves were constructed, and discriminant analysis techniques were used to classify each child based on the total score. RESULTS: We found conductive hearing loss in 39.3 percent of children, sensorineural hearing loss in 7.4 percent and normal hearing in 53.3 percent. The discriminant analysis technique provided the following classification rule for the total score on the questionnaire: 0 to 4 points - normal hearing; 5 to 7 points - conductive hearing loss; over 7 points - sensorineural hearing loss. CONCLUSION: Our results suggest that the questionnaire could be used as a screening tool to classify children with normal hearing or hearing loss and according to the type of hearing loss based on the total questionnaire score.


Subject(s)
Child , Child, Preschool , Female , Humans , Male , Developing Countries , Hearing Tests , Hearing Loss/diagnosis , Parents , Surveys and Questionnaires/standards , Brazil/epidemiology , Developing Countries/statistics & numerical data , Epidemiologic Methods , Family Health , Government Programs/methods , Government Programs/standards , Hearing Loss/classification , Hearing Loss/epidemiology , Mass Screening/economics , Mass Screening/methods
6.
Ciênc. saúde coletiva ; 15(5): 2611-2620, ago. 2010. tab
Article in Portuguese | LILACS (Americas) | ID: lil-555617

ABSTRACT

Este estudo objetivou verificar as necessidades para a capacitação e aperfeiçoamento dos profissionais das equipes de saúde da família dos 31 municípios que compõe a 4ª Coordenadoria Regional de Saúde do Estado do Rio Grande do Sul. A coleta de dados foi realizada através da aplicação de um questionário com questões objetivas, composto de duas partes: campo e núcleo de competências. Para análise dos dados obtidos, foram utilizados testes de normalidade, qui-quadrado e teste G para as atribuições fáceis e difíceis indicadas pelos profissionais. Os profissionais mostraram menores dificuldades com atribuições genéricas, relacionadas a métodos e técnicas básicas de cada área de formação. Porém, revelaram dificuldades tais como a busca de parcerias nas comunidades, estimulação da participação popular na discussão sobre direitos à saúde e o preenchimento dos formulários do SIA/SIAB. Mesmo após doze anos da criação do Programa de Saúde da Família (PSF), observam-se ainda várias dificuldades em atuar de forma adequada e necessária a este novo modelo de trabalho em saúde. São propostas medidas que visam auxiliar e consolidar o PSF em seus diversos níveis.


This study had the aim to verify the necessities of training and improvement of the 4th Regional Coordination in Health of Rio Grande do Sul State family health teams. The data collection was carried out through the application of questionnaires with objective questions, composed by two parts: field and competence nucleus. For data analyses, Normality, Chi-Square and G tests were used as statistical procedures for Easy and Difficult attributions indicated by the professionals. Professionals have shown less difficulty with generic attributions, related with basic methods and techniques of each health area. However, they have revealed a lot of difficulties with attributions relating to the search of new partners in health inside communities, stimulation of the people participation in the discussion of health rights, and completion of the SIA/SIAB forms, and others. Even after 12 years of the foundation of the Family Health Program (PSF), several difficulties are still observed concerning the way to work with this new health strategy in Brazil. Proposals are made for the complete understanding and improvement of the PSF strategy.


Subject(s)
Adult , Female , Humans , Male , Young Adult , Family Health , Government Programs , Brazil , Government Programs/education , Government Programs/standards , Health Personnel/education , Health Personnel/standards , Young Adult
7.
Arq. bras. cardiol ; 93(6): 645-650, dez. 2009. tab
Article in English, Spanish, Portuguese | LILACS (Americas) | ID: lil-542747

ABSTRACT

Fundamento: A redução da morbi-mortalidade pelas doenças do aparelho circulatório (DAC) é um dos maiores desafios da atenção básica, e a atuação da Saúde da Família possibilita o acesso às medidas multissetoriais e integrais que a abordagem dessas doenças exige. Objetivo: Analisar a mortalidade e a internação hospitalar, por DAC, antes e após a implantação da Saúde da Família em Londrina-PR. Métodos: Estudo de agregados, comparando-se os coeficientes de mortalidade e de internação hospitalar pelo SUS, por DAC, doença cerebrovascular (DCbV) e doença isquêmica do coração (DIC), de residentes em Londrina, em dois quadriênios: 1997 a 2000 e 2002 a 2005. Os dados foram obtidos no Sistema de Informações sobre Mortalidade e no Sistema de Informações Hospitalares do SUS. Foram calculadas razões entre as taxas nos dois períodos e os respectivos intervalos de 95 por cento de confiança. Resultados: As DAC mantiveram-se como a primeira causa de morte no município nos dois quadriênios. As DCbV e as DIC responderam por mais de 63 por cento das mortes por DAC. Na comparação dos dois quadriênios, observou-se a redução das taxas de mortalidade por DCbV, significativa apenas em maiores de 59 anos, em ambos os sexos, e o aumento da internação em 10 por cento. Para as DIC não houve alteração significativa na mortalidade e ocorreu um aumento de 40 por cento na taxa de internação. Conclusão: A redução significativa apenas na mortalidade por DCbV em idosos sugere a necessidade de ampliar a cobertura assistencial aos diferentes grupos populacionais e o desenvolvimento de ações de caráter preventivo e de promoção à saúde.


Background: The reduction in morbidity and mortality rates from diseases of the circulatory system (DCS) is one of the greatest challenges in primary care, and the implementation of the Family Health Program provides access to the multisectoral and integrated measures required for dealing with these diseases. Objective: To analyze DCS mortality and hospitalization rates before and after the implementation of the Family Health Program, in Londrina, Paraná. Methods: This was an ecological study, comparing DCS, cerebrovascular disease (CbVD) and ischemic heart disease (IHD) mortality rates and hospitalization rates by the SUS, in residents of Londrina, in two 4-year periods: 1997 to 2000, and 2002 to 2005. The data were obtained from the Mortality Information System and the Hospital Information System of the SUS. The ratios between the rates were calculated for both periods at 95 percent confidence interval. Results: The DCS was the first cause of death in the city, in both quadrennia. The CbVD and IHD accounted for more than 63 percent of DCS deaths. In comparing the two quadrennia, there was a reduction in CbVD mortality rates, which was significant only for subjects over 59 years, in both genders, and the hospitalization rates increased by 10 percent. For IHD, no significant change occurred in mortality rates, and there was a 40 percent increase in hospitalization rates. Conclusion: The significant reduction only in CbVD mortality in the elderly suggests the need for expanding health assistance coverage to different population groups and the development of preventive and health promotion measures.


Fundamento: La reducción de la morbimortalidad en las enfermedades del aparato circulatorio (EAC) es uno de los mayores desafíos de la atención básica, y la acción de Salud de la Familia posibilita el acceso a las medidas multisectoriales e integrales que el abordaje de esas enfermedades exige. Objetivo: Analizar la mortalidad y la internación hospitalaria por EAC, antes y después de la implantación de Salud de la Familia en Londrina-PR. Método: Estudio de agregación, comparando los coeficientes de mortalidad y de internación hospitalaria del SUS, por EAC, enfermedad cerebrovascular (ECbV) y enfermedad isquémica del corazón (EIC), de residentes en Londrina, en dos cuadrienios: 1997 a 2000 y 2002 a 2005. Los datos se obtuvieron mediante el Sistema de Informaciones sobre Mortalidad y el Sistema de Informaciones Hospitalarias del SUS. Se calcularon las razones de las tasas en los dos períodos y los respectivos intervalos de 95 por ciento de confianza. Resultados: Las EAC se mantuvieron como la primera causa de muerte en el municipio en los dos cuadrienios. Las ECbV y las EIC fueron responsables de más del 63 por ciento de las muertes por EAC. En la comparación de los dos cuadrienios, se observó reducción de las tasas de mortalidad por ECbV, significativa sólo en mayores de 59 años, en ambos sexos, y aumento de la internación en un 10 por ciento. No existió alteración significativa en la mortalidad por EIC y hubo un aumento del 40 por ciento en la tasa de internación. Conclusión: La reducción significativa sólo en la mortalidad por ECbV en ancianos sugiere la necesidad de ampliar la cobertura asistencial a los diferentes grupos poblacionales y desarrollar acciones de carácter preventivo y de promoción de la salud.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cardiovascular Diseases/mortality , Cerebrovascular Disorders/mortality , Family Health , Government Programs , Hospitalization/statistics & numerical data , Age Distribution , Brazil/epidemiology , Cardiovascular Diseases/prevention & control , Cause of Death/trends , Cerebrovascular Disorders/prevention & control , Government Programs/standards , Hospitalization/trends , Program Evaluation , Sex Distribution , Time Factors
8.
Ceylon Med J ; 2008 Dec; 53(4): 121-7
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-49038

ABSTRACT

OBJECTIVE: To assess the quality of care in government family planning clinic services in Colombo District. DESIGN: Descriptive cross-sectional study. SETTINGS: Government family planning clinics in the Colombo District. STUDY SAMPLE: The study was conducted in 23 government family planning clinics in the Colombo District selected through stratified sampling. 593 women visiting these clinics for family planning services were interviewed and 242 client-provider interactions were observed. MEASUREMENTS: Client exit interviews, observations of service delivery and clinic inventories were used as survey tools to assess the quality in preparedness of the clinics, the service delivery process and client satisfaction, as outcomes of the service. A set of indicators were identified for this purpose. RESULTS: The study showed deficiencies in infrastructure, interpersonal relations, privacy, information to clients, especially on side-effects and warning signs, and in the mechanisms to ensure continuity. The majority of clients were satisfied with many aspects of the service such as the family planning method received (94.5%), confidentiality of information shared with the provider (96.1%), competency of provider (97.5%), and physical access to clinics (92.3%). However, many were dissatisfied with the physical conditions of the clinics (> 20%), information received (12.5%), opportunity given to discuss their problems with the service providers (18.8%) and waiting times (26.6%). CONCLUSIONS: Government family planning clinic services need improvement through upgrading of clinic infrastructure, better planning and management of clinic services, regular training of service providers and establishing of a system to monitor service quality.


Subject(s)
Adolescent , Adult , Contraceptives, Oral , Cross-Sectional Studies , Family Planning Services/standards , Female , Government Programs/standards , Humans , Interviews as Topic , Male , Middle Aged , Models, Theoretical , Patient Satisfaction , Quality of Health Care/standards , Surveys and Questionnaires , Victoria , Young Adult
11.
São Paulo; Secretaria da Saúde; nov. 2000. 32 p.
Monography in Portuguese | LILACS (Americas), ColecionaSUS, SES-SP, SESSP-CTDPROD, SES-SP, SESSP-ACVSES | ID: biblio-932920
SELECTION OF CITATIONS
SEARCH DETAIL