RESUMO
Problema: Os direitos fundamentais das pessoas transgênero são negados cotidianamente. Neste cenário, o preconceito age como determinante social de saúde impactando na prevalência de problemas como saúde mental e infecções sexualmente transmissíveis (ISTs). O objetivo foi o desenvolvimento de um sumário de evidências para apoiar o atendimento clínico e embasar a capacitação dos profissionais da Atenção Primária de Saúde de Florianópolis - SC, a fim de melhorar os resultados de saúde dessa população. Métodos: Baseado na ferramenta PACK interface acessível e intuitiva no modelo pergunte, solicite, aconselhe e trate já implementada no município de Florianópolis. O método de revisão rápida foi utilizado para busca de evidência, priorizando sumários de prática clínica e protocolos internacionais. Fontes primárias foram utilizadas quando os dados anteriores eram insuficientes ou conflitantes. As perguntas de pesquisa seguiram o acrônimo PICO e a recomendação foi classificada de acordo com a adaptação GRADE do Center of Excellence for Transegender Health. Resultados: Foi criado o Guia Rápido para Prática de Atenção à Saúde da População Transgênero aos moldes do PACK Brasil. O mesmo aguarda aprovação do PACK Brasil e do Ambulatório de Atenção Integral à População Transexual de Florianópolis para futura incorporação do material. Conclusão: Apesar da falta de evidência de qualidade e estudos voltados para a população específica, a existência de diretrizes nesse campo legitima a necessidade de atenção à saúde transgênero, além de auxiliar profissionais de saúde e formuladores de políticas sobre como atender a essas necessidades. Na perspectiva de redução de danos, devemos transpor a barreira do estigma social e institucional para produção de diretrizes consensuais em busca de equidade para população transgênero.
Problem: The fundamental rights of transgender people are denied daily. In this scenario, prejudice acts as a social determinant of health impacting on the prevalence of conditions such as mental health and STIs. The objective was to develop a summary of evidence to support clinical care and support the training of Primary Health Care professionals in Florianópolis - SC, in order to improve the health outcomes of this population. Methods:Based on the PACK tool - accessible and intuitive interface in the ask, request, advise and treat model - already implemented in the municipality of Florianópolis. The rapid review method was used to search for evidence, prioritizing clinical practice summaries and international protocols. Primary sources were used when previous data were insufficient or conflicting. The research questions followed the acronym PICO and the recommendation was classified according to the GRADE adaptation of the Center of Excellence for Transgender Health. Results: The Quick Guide for the Health Care Practice of Transgender Population was created according to the mold of PACK Brazil. It is awaiting approval from PACK Brazil and the Ambulatory of Integral Attention to the Transsexual Population of Florianópolis for future incorporation of the material. Conclusion: Despite the lack of quality evidence and studies focused on the specific population, the existence of guidelines in this field legitimizes the need for transgender health care, in addition to assisting health professionals and policy makers on how to address these needs. In the perspective of harm reduction, we must overcome the barrier of social and institutional stigma to produce consensual guidelines in search of equity for the transgender population.
Problem: The fundamental rights of transgender people are denied daily. In this scenario, prejudice acts as a social determinant of health impacting on the prevalence of conditions such as mental health and STIs. The objective was to develop a summary of evidence to support clinical care and support the training of Primary Health Care professionals in Florianópolis - SC, in order to improve the health outcomes of this population. Methods:Based on the PACK tool - accessible and intuitive interface in the ask, request, advise and treat model - already implemented in the municipality of Florianópolis. The rapid review method was used to search for evidence, prioritizing clinical practice summaries and international protocols. Primary sources were used when previous data were insufficient or conflicting. The research questions followed the acronym PICO and the recommendation was classified according to the GRADE adaptation of the Center of Excellence for Transgender Health. Results: The Quick Guide for the Health Care Practice of Transgender Population was created according to the mold of PACK Brazil. It is awaiting approval from PACK Brazil and the Ambulatory of Integral Attention to the Transsexual Population of Florianópolis for future incorporation of the material. Conclusion: Despite the lack of quality evidence and studies focused on the specific population, the existence of guidelines in this field legitimizes the need for transgender health care, in addition to assisting health professionals and policy makers on how to address these needs. In the perspective of harm reduction, we must overcome the barrier of social and institutional stigma to produce consensual guidelines in search of equity for the transgender population.
Assuntos
Humanos , Atenção Primária à Saúde , Guia de Prática Clínica , Pessoas TransgêneroRESUMO
The Mais Médicos (More Doctors) Program seeks to broaden access to health by providing medical professionals, investments in health units and multi-professional integration geared to the Family Health Strategy. Vale do Ribeira includes 25 cities and is among the most vulnerable regions in São Paulo. It has been allocated 41 physicians from the Program. This study is to evaluate access to health, comparing health indicators before and after the Program. We collected data from DATASUS, SIAB, and the Ministry of Health. There was a marked increase in the number of appointments for infants under one year of age, adults, the elderly, STD/HIV patients and group patient care. There was a decrease in appointments outside the catchment area, as well as hospital admissions for other causes, mothers exclusively breastfeeding their infants up to four months. We concluded that after deployment of the Program, there was an increase in health access and health promotion focused on an area that presents an enormous challenge for Primary Health Care (PHC). It would seem that, since this is a high vulnerability area with a large area for care, hospital admissions for PHC care-sensitive conditions, as well as referrals for secondary services, did not decrease.
Assuntos
Atenção à Saúde , Programas Governamentais , Acessibilidade aos Serviços de Saúde/organização & administração , Médicos/provisão & distribuição , Populações Vulneráveis , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Pessoa de Meia-Idade , Recursos Humanos , Adulto JovemRESUMO
Resumo O Programa Mais Médicos visa ampliar o acesso à saúde em áreas provendo profissionais médicos, investimentos nas unidades de saúde e integração multiprofissional voltada à Estratégia de Saúde da Família. O Vale do Ribeira abriga 25 municípios e figura entre as regiões mais vulneráveis do estado e recebeu 41 médicos do PMM. O objetivo deste estudo é avaliar o acesso à saúde, comparando indicadores de produção, marcadores e situação de saúde antes e depois da implementação do PMM. Foram coletados dados do DATASUS, SIAB e Ministério da Saúde. Houve aumento em número de consultas de crianças menores de um ano, adultos, idosos, DST/AIDS e atendimento em grupos. Houve redução no número de consultas fora de área de abrangência, de hospitalizações por outras causas e no aleitamento materno exclusivo até quatro meses. Concluímos que após a implementação do programa houve melhora no acesso à saúde e no trabalho de promoção de saúde focado no território, um grande desafio na Atenção Primária à Saúde (APS). Supõe-se que por se tratar de área de alta vulnerabilidade e pressão assistencial, as internações por causas sensíveis à APS, assim como o encaminhamento aos serviços secundários, não tenham sido reduzidas a curto prazo.
Abstract The Mais Médicos (More Doctors) Program seeks to broaden access to health by providing medical professionals, investments in health units and multi-professional integration geared to the Family Health Strategy. Vale do Ribeira includes 25 cities and is among the most vulnerable regions in São Paulo. It has been allocated 41 physicians from the Program. This study is to evaluate access to health, comparing health indicators before and after the Program. We collected data from DATASUS, SIAB, and the Ministry of Health. There was a marked increase in the number of appointments for infants under one year of age, adults, the elderly, STD/HIV patients and group patient care. There was a decrease in appointments outside the catchment area, as well as hospital admissions for other causes, mothers exclusively breastfeeding their infants up to four months. We concluded that after deployment of the Program, there was an increase in health access and health promotion focused on an area that presents an enormous challenge for Primary Health Care (PHC). It would seem that, since this is a high vulnerability area with a large area for care, hospital admissions for PHC care-sensitive conditions, as well as referrals for secondary services, did not decrease.
