Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibility features for people with other visual or hearing impairments (6.3, SD = 1.0). Scores were consistently better in the least poor regions of Brazil and in facilities in larger municipality size (indicating more urban areas). In conclusion, large-scale accessibility audits are feasible to undertake. Poor accessibility means that people with disabilities will experience difficulties in accessing healthcare, and this is a violation of their rights according to international and Brazilian laws.
Resumo: O objetivo é apresentar uma revisão sistemática da literatura científica que busca compreender a partir da literatura levantada quais as concepções e/ou estratégias que têm sido desenvolvidas a respeito da prevenção de álcool, crack e outras drogas em contexto escolar com adolescentes e os fatores de risco envoltos ao uso. Pela base BVS e Periódico Capes (2006-2016), a partir de critérios de inclusão/exclusão, foram recuperados e analisados 19 trabalhos. Os estudos abordam os fatores de risco e proteção relacionados ao uso de drogas e a relação destes com as abordagens realizadas em contexto escolar em relação às drogas, a partir de ações de Educação em Saúde. Entre as principais contribuições apresentadas estão possibilidades de intervenções ancoradas em métodos interventivos para a promoção em saúde com enfoque na participação ativa dos adolescentes. Constatou-se a necessidade de investimento em processos contínuos de educação em saúde que incluam a formação de professores para atuação na temática de drogas.Palavras-chave: Drogas; Educação; Educação em saúde; Escola. Abstract: The aim of this study was to present a systematic review that seeks to understand, from the scientific literature, which conceptions and / or strategies have been developed in the prevention of alcohol and other drugs in the school context with adolescents and the related risk factors. Based on the VHL and Periódico Capes database (2006-2016), based on eligibility criteria, 19 studies were retrieved and analyzed. The studies address the risk and protection factors related to drug use and the relationship with approaches carried out in the school context on drugs, based on Health Education actions. The main contributions presented are interventions anchored in interventional methods for health promotion with focus on the active participation of adolescents. There was a need to invest in continuous health education processes that include the training of teachers to work on drugs.Keywords: Drugs; Education; Health education; School.
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