Resumo: A discriminação e, como consequência, a exclusão social sofrida pelas travestis e transexuais pode limitar e afastar seu acesso aos serviços de saúde. Como forma de combate às discriminações contra essa população, o uso do nome social nos serviços de saúde é garantido entre os direitos dos usuários do SUS. Objetivamos discutir o uso do nome social no SUS como ferramenta para efetivação do acolhimento, humanização e integralidade da assistência a travestis e transexuais, através da elaboração de um ensaio teórico-reflexivo. Elegeramse como categorias de análises: o acolhimento e a promoção do acesso à saúde através do nome social; o nome social como ferramenta para humanização da assistência; e o nome social como base para efetivação da integralidade. Podemos afirmar que o nome social se apresenta como a senha de acesso das travestis e transexuais ao SUS. A partir da efetivação desse direito por parte dos profissionais, respeitando e disponibilizando meios para seu uso oral e nos prontuários e documentos, facilita-se a execução das ações em saúde, fazendo valer os direitos de cidadania e de saúde destes usuários. Palavras-chave: pessoas transgêneros; identidade de gênero; integralidade em saúde.
Objective:To carry out a documentary study on the rules, guidelines, policies and
institutional support for the nurse to prescribe medicines and request tests
with a view to the advanced practice in the scope of Primary Health Care.
Methods:Documentary research using open-access institutional documents - Federal
Nursing Council (COFEN), its regional representations in the respective
Brazilian states (COREN) and the Brazilian Nursing Association (ABEN). Results:Most of the news/notices were issued by the Regional Nursing Councils in the
different Federative Units. The argumentation regarding the prescription of
medicines and request for tests by nurses is based on three categories:
Autonomy and competencies for the prescription of medicines and/or request
of tests; Corporate policies that undermine the full exercise of nursing;
and Transformation of health and nursing care in Primary Health Care. Conclusion:The prescriptive practice by nurses integrates health care and has been
defended by the institutions that represent the category. It emerges as an
important element of advanced practice and in the transformation of care in
the context of health teams.
This study aims to evaluate the social determinants of access to HIV and VDRL tests during pregnancy in Brazil. The dependent variables were based on prenatal care access: prenatal care appointments, no HIV and syphilis tests. The independent variables at the first level were formal education level, age, race, work and participation in the Family Income program conditional cash transfer program. The city-level variables were the human development index (HDI), Gini index, and indicators related to health services. An exploratory analysis was performed assessing the effect of each level through prevalence ratios (PR) calculation. A multilevel mixed-effect Poisson regression model was constructed for all outcomes to verify the effect of individual level and with both the individual and contextual levels. Regarding prenatal appointments, the main implicated factors were related to individual socioeconomic position (education level and participation in the Family Income Program conditional cash transfer program), however only HDI maintained significance for the city-level context. The city-level variance dropped from 0.049 to 0.042, indicating an important between-city effect. Regarding the outcomes performing tests in prenatal care, the worst conditions such as contextual (HDI > 0.694, p < 0.001; Gini index ≥ 0.521, p < 0.001) and individual (> 8 years of schooling, p < 0.001) showed a risk effect in the final model. Variables related to health services did not show significant effects. They were associated with individual socioeconomic position and a city-level contextual effect. These findings indicate the importance of strengthening HIV and syphilis infection control programs during pregnancy.
Objective: to analyze the influence of contextual indicators on the performance of
municipalities regarding potential access to primary health care in Brazil and to
discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation
of the National Program for Access and Quality Improvement in Primary Care, with
the participation of 17,202 primary care teams. The chi-square test of proportions
was used to verify differences between the municipalities stratified based on size
of the coverage area, supply, coordination, and integration; when necessary, the
chi-square test with Yates correction or Fisher's exact test were employed. For
the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically
significant differences were observed between the municipalities in terms of
territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000),
integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities
that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a
leading role in the potential to access primary health care in Brazil.
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OBJECTIVE: to verify whether the tuberculosis control program (TCP) is evaluable and to
examine the feasibility of building an evaluation model in apriority municipality
for the control of tuberculosis. METHOD: this evaluability study was conducted in a municipality in northeastern Brazil.
For data collection, documental analysis and interviews with key informants were
performed. For indicator validation, the nominal group technique was adopted. RESULTS: the details of TCP were described, and both the logical model and the
classification framework for indicators were developed and agreed up on, with the
goal of characterizing the structural elements of the program, defining the
structure and process indicators, and formulating the evaluation questions. CONCLUSION: TCP is evaluable. Based on logical operational analysis, it was possible to
evaluate the adequacy of the program goals for the control of tuberculosis.
Therefore, the performance of a summative evaluation is recommended, with a focus
on the analysis of the effects of tuberculosis control interventions on decreasing
morbidity and mortality.
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