Access to child care services in the Northeast and in the South Regions of Brazil / Acesso ao atendimento de puericultura nas Regiões Nordeste e Sul do Brasil

ABSTRACT

Abstract Objectives: to estimate the incomplete follow-up on child care services and the associated factors in the municipalities in the Northeast and in the South of Brazil. Methods: a population-based cross-sectional study with 7,915 children. The incomplete follow-up on child care regarded the absence of at least one of the seven advocated care services. The Poisson regression was used for crude and adjusted analysis. Results: the prevalence of the incomplete follow-up child care was 53.6% (CI95%= 52.5-54.7) in the Northeast and 28.3% (CI95%= 27.3-29.3) in the South, therefore 91% was greater in the Northeast (PR=1.91; CI95%= 1.73-2.11). Protector effect was observed in the muni-cipalities with 30 to 49 thousand inhabitants in the Northeast (PR= 0.72; CI95%= 0.64-0.82) and 100 to 999 thousand inhabitants in the South (PR=0.69; CI95%= 0.57-0.84); the South has the greatest income quartile (RP=0.77; CI95%= 0.63-0.95) and has six or more prenatal consultations (PR=0.83; CI95%= 0.75-0.92) in the Northeast and (PR=0.65; CI95%= 0.53-0.79) in the South. Social classes D and E showed risks (PR=1.41; CI95%= 1.19-1.67) in the Northeast and (PR=1.67; CI95%= 1.37-2.03) in the South. Conclusions: children in the Northeast are more likely not to have a complete child care follow-up, implying that the user does not come to be attended or finds difficulties to have access to the health services.

RESUMO

Resumo Objetivos: estimar o acompanhamento incompleto de puericultura e os fatores associados, em municípios do Nordeste e Sul do Brasil. Métodos: estudo transversal, de base populacional, realizado com 7.915 crianças. Considerou-se acompanhamento incompleto da puericultura a ausência em pelo menos um dos sete atendimentos preconizados. Utilizou-se Regressão de Poisson para análise bruta e ajustada. Resultados: a prevalência do acompanhamento incompleto da puericultura foi de 53,6% (IC95%= 52,5-54,7) no Nordeste e de 28,3% (IC95%= 27,3-29,3) no Sul, sendo 91% maior no Nordeste (RP=1,91; IC95% 1,73-2,11). Efeito protetor foi observado em municípios com 30 a 49 mil habitantes no Nordeste (RP= 0,72; IC95%= 0,64-0,82) e 100 a 999 mil habitantes no Sul (RP=0,69; IC95% 0,57-0,84); pertencer ao maior quartil de renda per capita no Sul (RP=0,77; IC95% 0,63-0,95) e fazer seis ou mais consultas de pré-natal (RP=0,83; IC95%=0,75-0,92) Nordeste e (RP=0,65; IC95%= 0,53-0,79) Sul. Pertencer às classes D e E evidenciou risco no Nordeste (RP=1,41; IC95%= 1,19-1,67) e no Sul (RP=1,67; IC95%=1,37-2,03). Conclusões: as crianças no Nordeste estão mais sujeitas a não seguir o acompanhamento completo de puericultura, sugerindo que o usuário não comparece ou encontra dificuldades nos acesso aos serviços de saúde.