Saúde infantil: condições de vida e utilização de serviços de saúde em área da Região Metropolitana de São Paulo, 1996

Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

[Overweight and obesity in prepubertal schoolchildren: the association with low birth weight and family antecedents of cardiovascular disease. Embu - metropolitan region of São Paulo, 2006]

The aim was to determine the prevalence of overweight and obesity in schoolchildren and the association with birth weight and family antecedents of cardiovascular disease. This cross-sectional study used a probabilistic sample of 929 schoolchildren aged 6 to 10 years. The variables were: body mass index (BMI), birth weight and family antecedents of cardiovascular disease. The statistical analysis consisted of the chi-square test (Pearson) and odds ratio, as association measurements. Of the schoolchildren (54.6% of which were female), 14.4% and 13.3% were overweight and obese, respectively. Low birth weight was reported among 9.4% and family antecedents of cardiovascular disease among 35.2%. Overweight or obesity (BMI e" P85) was associated with the presence of family antecedents of cardiovascular disease (OR = 1.66; 95% CI 1.23-2.23) and male sex (OR = 1.37; 95%CI 1.02-1.83); there was no association with birth weight. The results indicate the need for preventive actions for children with family antecedents of cardiovascular disease.

[Profile and process of the care provided to high-risk newborns in southern Brazil]

OBJECTIVE

To describe newborns at risk and check the process of care provided by the High Risk Newborn Surveillance Program in Maringá-PR.

METHODS

Data were collected from medical records and monitoring sheets of a stratified sample consisting of 505 newborns at risk, born in 2007. Maternal and neonatal care were analyzed descriptively using Statistica 7.1 software.

RESULTS

The program only considered biological risks as inclusion criteria, whether they appeared alone (63.2%) or associated (36.8%). Regarding mothers, 71.5% were adults, 78.2% had > 8 years of schooling, 57.2% were single parents, 55.3% had an unpaid occupation, 69.5% had > 6 prenatal visits, 87.3% had a single baby, and 65.4% had a C-section. Regarding newborns at risk, 51% were male, 50.3% had low birth weight, 51.5% were full term, 95.8% without congenital anomalies, and 90.3% with 5th minute scores > 7. Regarding care provided to children at risk, 69.5% were accompanied by the Program, 71% of the medical records were located, for 82.6% there were no home visits, 8.9% received > 12 medical consultations, 33.1% had not received any guidance, 5.8% were hospitalized, 18.7% were weighed > 12 times, and 19.8% presented full immunization records.

CONCLUSION

It is necessary to reorganize primary care to ensure integral care and for ongoing monitoring of the bio-psychosocial development and growth of children at risk.

The expression of vulnerability through infant mortality in the municipality of Embu

CONTEXT AND OBJECTIVE

Infant mortality expresses a set of living, working and healthcare access conditions and opens up possibilities for adopting interventions to expand equity in healthcare. This study aimed to investigate vulnerability and the consequent differences in access to health services and occurrences of deaths among infants under one year of age in the municipality of Embu.

DESIGN AND SETTING

This was a descriptive study in the municipality of Embu.

METHODS

Primary data were collected through interviews with the families of children living in the municipality of Embu who died in the years 1996 and 1997 before reaching one year of age. Secondary data were obtained from death certificates. The variables collected related to living conditions, income, occupation, prenatal care, delivery and the healthcare provided for children. These data were compared with the results obtained from a study carried out in 1996.

RESULTS

Statistically significant differences were found with regard to income, working without a formal employment contract and access to private health plans among the families of the children who died. There were also differences in access to and quality of prenatal care, frequency of low birth weight and neonatal inter-ocurrences.

CONCLUSIONS

The employment/unemployment situation was decisive in determining the degree of family stability and vulnerability to the occurrence of infant deaths, in addition to the conditions of access to and quality of healthcare services.

Prevalência de aleitamento materno e introdução precoce de suplementos alimentares em área urbana do Sudeste do Brasil, Embu, SP

OBJETIVOS: estimar a prevalência do aleitamento materno em Embu, utilizando indicadores da Organização Mundial de Saúde; investigar a associação dos eventos "não início do aleitamento materno" e "introdução precoce de suplementos alimentares" com fatores sociodemográficos e relacionados à assistência à saúde. MÉTODOS: estudo transversal analítico, domiciliar, com amostragem por conglomerados em dois estágios (sorteio sistemático) - parte do projeto "Morbidade e Utilização de Serviços de Saúde". População: 798 menores de três anos, residentes no Embu em 1996. RESULTADOS: aleitamento materno - 95,7% (IC95%: 93,2-98,2) dos menores de um ano; aleitamento exclusivo - 10,3% (IC95%: 2,9-17,6); predominante - 32,3% (IC95%: 23,5-41,2); duração mediana do aleitamento: seis meses. Fatores associados à introdução precoce de suplementos (uso de outros alimentos, exceto água ou chás, antes de 120 dias): residir em favela - OR = 3,70 (IC95%; 2,01-6,81); alta hospitalar do recém-nascido após cinco dias de vida - OR = 6,12 (IC95%: 1,64-22,80); mãe com 30 anos ou mais - OR = 1,70 (IC95%: 1,01-2,86). CONCLUSÕES: foram caracterizados grupos priori-tários para intervenção em aleitamento materno, apontando para a necessidade de novos estudos, além de ações dirigidas à população favelada e à melhora da assistência pré e perinatal.