Resumo: O objetivo do estudo foi avaliar a disponibilidade de insumos para o planejamento reprodutivo em unidades básicas de saúde (UBS) que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), e sua distribuição segundo fatores contextuais. Estudo de comparação dos três ciclos do PMAQ-AB (2012, 2014 e 2018). Foi avaliada a disponibilidade física na UBS de etinilestradiol + levonorgestrel, noretisterona, noretisterona + estradiol, levonorgestrel, medroxiprogesterona, preservativos masculino e feminino, DIU e teste rápido de gravidez. Considerou-se disponibilidade adequada a presença de todos os insumos. A disponibilidade foi avaliada segundo fatores contextuais do município sede da UBS. A disponibilidade de todos os insumos aumentou de 1,5% para 10,9%. Em todos os ciclos avaliados, etinilestradiol + levonorgestrel e preservativo masculino apresentaram a maior disponibilidade e DIU a menor. A disponibilidade de cada insumo também aumentou, sendo o maior aumento de 36p.p. para preservativo feminino, teste rápido de gravidez e noretisterona + estradiol, e o menor de 15p.p. para etinilestradiol + levonorgestrel, noretisterona e DIU. A Região Norte apresentou os piores resultados. Os maiores incrementos foram nas UBS de municípios com o menor IDH e nas que aderiram a todos os ciclos do PMAQ. Somente os preservativos estão amplamente disponíveis, é importante ampliar a disponibilidade dos demais insumos, principalmente de DIU e teste rápido de gravidez. Houve promoção de equidade no período, mas é preciso superar as desigualdades regionais. É fundamental monitorar a disponibilidade dos insumos para qualificar o planejamento reprodutivo.

OBJECTIVETo describe the planning, sampling, operational aspects of the field, and the sample obtained during a research conducted in a rural area, specifying and discussing the main logistical difficulties unique to these places and the solutions adopted.METHODSWe carried out a population-based, cross-sectional survey between January and June 2016, with a representative sample of the population aged 18 years or over living in the rural area of Pelotas (approximately 22,000 individuals), State of Rio Grande do Sul, Brazil. We collected demographic, socioeconomic, and health-related information, such as alcohol consumption, cigarette consumption, depressive symptoms, quality of diet, quality of life, physical activity, satisfaction with the health unit, overweight or obesity, and sleep problems.RESULTSIn the 720 domiciles sampled, 1,697 individuals were identified and 1,519 were interviewed (89.5%). The study initially drew 24 census tracts and proposed the visit to 42 households per tract; however, we need to adjust the method, such as decreasing the number of households per census tract (from 42 to 30) and identifying housing centers in each tract. The main reasons for these changes were difficulty accessing the area, large distances between households, misconceptions in the satellite data available (which did not fit the reality), and high cost of the field work.CONCLUSIONSThe previous detailed recognition of the research environment was crucial for decision making as the maps and territory had geographical inconsistencies. The strategies and techniques used in studies for the urban area are not applicable to the rural area given the outcomes observed in Pelotas. The decisions taken, keeping the methodological rigor, were essential to ensure the timely execution of the study with the financial resources available.

PurposeUrban violence is a major problem in Brazil and may contribute to mental disorders among victims. The aim of this study was to assess the association between robbery victimisation and mental health disorders in late adolescence.MethodsAt age 18 years, 4106 participants in the 1993 Pelotas Birth Cohort Study were assessed. A questionnaire about history of robbery victimisation was administered, the Self-Report Questionnaire was used to screen for common mental disorders, and the Mini International Neuropsychiatric Interview was used to assess major depressive disorder and generalised anxiety disorder. Cross-sectional prevalence ratios between lifetime robbery victimisation and mental disorders were estimated using Poisson regression with robust standard errors, adjusting for socioeconomic variables measured at birth and violence in the home and maltreatment measured at age 15.ResultsThere was a dose–response relationship between frequency of lifetime robberies and risk of mental disorders. Adolescents who had been robbed three or more times had twice the risk (PR 2.04; 95% CI 1.64–2.56) for common mental disorders, over four times the risk for depression (PR 4.59; 95% CI 2.60–8.12), and twice the risk for anxiety (PR 1.93; 95% CI 1.06–3.50), compared with non-victims, adjusting for covariates. Experiencing frequent robberies had greater impact on common mental disorders than experiencing an armed robbery. Population attributable fractions with regard to robbery were 9% for common mental disorders, 13% for depression, and 8% for anxiety.ConclusionsRobberies are associated with common mental disorders in late adolescence, independently of violence between family members. Reducing urban violence could significantly help in preventing common mental illnesses.Electronic supplementary materialThe online version of this article (10.1007/s00127-018-1488-z) contains supplementary material, which is available to authorized users.

Introduction: Self-assessment of health status can be considered a good predictor of population morbidity and mortality. Sociodemographic, environmental and health conditions can influence health self-perception. However, in rural areas, the identification of morbidities that affect workers' health and their general health condition is unknown. This study aims to evaluate the relationship between health self-perception and the occurrence of morbidities according to type of work.Methods: This was a cross-sectional, population-based study of a rural area of Brazil. Health self-perception outcomes were classified as good (very good or good) or not good (fair, poor or very poor).Rural work, classified as yes or no, was considered to be the Rural and Remote Health rrh.org.au

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Background The availability of contraceptive methods is a main determinant of their use and diversification is necessary to meet the reproductive health needs of women at different stages of life, in a universal and equitable way. The study aims to evaluate the availability of family planning supplies in Primary Care Units (PCU) in Brazil that adhered to the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB) in three evaluation cycles (2012, 2014, 2018), as well as, its distribution according to the Human Development Index (HDI), population size, Family Health Strategy (FHS) coverage and geographic region. Methods A descriptive cross-sectional study, of the more than 10.000 UBS included in the external evaluation of the PMAQ-AB. Availability was assessed by the physical presence of the following supplies: ethinyl estradiol + levonorgestrel, norethisterone, norethisterone + estradiol, levonorgestrel, medroxyprogesterone, male and female condom, IUD and rapid pregnancy test. The availability of all supplies at the PCU was considered adequate availability. Results The availability of supplies increased in the evaluated period. The lowest availabilities were IUD, 34.4% and rapid pregnancy test, 41.8%; the greatest were male condoms, 96.9%, and ethinyl estradiol + levonorgestrel, 85.2%. In Cycle III, adequate availability was 10.9%. The North had the worst results, followed by the Midwest region. HDI had little effect and population size had no effect on adequate availability, while FHS coverage was associated with greater availability. The PCUs of municipalities with a lower HDI had the largest increases in adequate availability. Adequate availability was greater in the PCUs that participated in all PMAQ-AB cycles. Conclusions Policies aimed at strengthening PHC increased the availability of supplies evaluated with equity promotion, however, regional inequities remain. The availability of a rapid pregnancy test and an IUD should be increased. Key messages Policies aimed at strengthening PHC, focusing infrastructure, provision and training professionals and quality monitoring increased the availability of family planning supplies with equity promotion. Monitoring the availability family planning supplies is essential for detecting failures, as the low availability of rapid pregnancy test, an essential supply for the early start of prenatal care.