Atividades do Senado Federal brasileiro na área de saúde pública, 1995 e 1996 / Activities of the Brazilian Senate in the field of public health, 1995 and 1996

RESUMO

O presente estudo buscou identificar e descrever as açoes dos senadores brasileiros, na área de saúde pública, no período de 1995 a 1996. Pretendeu-se também identificar a influência da profissao, regiao de origem e partido político sobre a atuaçao dos senadores. As açoes foram divididas em três grupos legislativas (proposiçao e apreciaçao de projetos de lei, pareceres e requerimentos), fiscalizadoras (requerimentos de informaçao ao Executivo e implementaçao de comissoes parlamentares de inquérito e especiais) e parlamentares (discursos). O levantamento dos dados foi realizado em duas bases de dados mantidas pelo Senado Federal MATE e DISC. Dos 89 parlamentares que exerceram mandato no período do estudo, 76 se envolveram com matérias de saúde. Foram estudadas 667 açoes. Predominaram os discursos (43 por cento das açoes), em sua maioria respondendo a notícias veiculadas pelos meios de comunicaçao. Do total de açoes, 60 por cento envolveram políticas públicas (30 por cento), drogas (9 por cento), regulamentaçao das profissoes de saúde (8 por cento), controle de doenças (7 por cento) e saúde do trabalhador (6 por cento). A atividade fiscalizadora foi limitada (5 por cento das açoes foram requerimentos de informaçao). En relaçao ao perfil dos senadores, predominaram os médicos, professores e jornalistas. Os parlamentares das Regioes Norte e Nordeste realizaram 62 por cento de todas as açoes e atuaram em relaçao a quase todos os temas. Os senadores de orientaçao liberal e de direita responderam por 43 por cento de todas as açoes; contudo, os de orientaçao socialista e trabalhista apresentaram maior participaçao proporcional (em termos de senadores envolvidos e de açoes realizadas). E interessante notar que os senadores socialistas e trabalhistas nao se envolveram com o tema "saúde do trabalhador". A predominância de discursos como açao, a proposiçao legislativa pontual e descontínua e, especialmente, a incipiente açao fiscalizadora, indicam a necessidade de reformular a sistemática de trabalho no âmbito das comissoes técnicas e da consultoria técnica do Senado

ABSTRACT

This study was intended to explore the conditions under which prenatal care is delivered in the border city of Tijuana, Baja California, Mexico, and to assess the possible associations between that care and neonatal results in terms of birthweight, health of the neonate, and prematurity. Seven hospitals serving persons from different socioeconomic strata were chosen, and between December 1993 and March 1994 interviews were conducted with 279 women who were in the first 24 to 48 hours of puerperium. During the interviews data were collected on socioeconomic level; the mothers' knowledge, attitudes, and practices concerning obstetric health; the mothers' perceptions of access to prenatal care; the quality of prenatal care visits (evaluated in terms of having blood and urine tested and weight and blood pressure measured); and the gynecological and obstetric and health history of the mother. A database was created using the SPSS statistics software package. Possible associations were explored, with prenatal care as the independent variable and various dependent variables, by means of contingency tables and a two-tailed Fisher's exact test. None of the neonates was premature, ill, or had a birthweight of £ 2 500 g. For this reason it was decided to divide the variable corresponding to birthweight into two groupings, £ 3 000 g and > 3 000 g. A significant (P < 0.00038) relationship was found between a lack of prenatal care and low birthweight. In addition, a lack of prenatal care was associated with low family income; the mother's financial dependence on the father; the mother being in an unmarried relationship; little communication with the partner; having no medical insurance; an unwanted pregnancy; and giving delivery at the General Hospital. Out of the total sample of 279 women, 15 (5.4%) had received no prenatal care. None of these 15 women reported they had encountered difficulties that prevented them from obtaining prenatal care, but only 7 of those women answered that question. The prenatal care was of good quality in 190 of the cases (68%). Both the number and the timing of the prenatal visits were adequate in 142 of the cases (50%). The mother's having worked during pregnancy or before had a positive predictive value in terms of utilization of prenatal care services. Additional studies are needed to evaluate the possible relationship between domestic violence and the lack of prenatal care or a delay in seeking such care.