Avaliação de competências de Agentes Comunitários de Saúde para coleta de dados epidemiológicosAssessment of competencies of community health workers for epidemiological data collection
BackgroundIn Brazil, community health workers have gathered monthly information on people with disabilities to maintain the Primary Care Information System since 1998; however, few studies have used this database for scientific or public health policy purposes.ObjectivesThis study aimed to evaluate the reliability of information on people with disabilities gathered by community health workers in primary care services.MethodThis was a cross-sectional population-based study conducted in two highly consanguineous communities, involving a population of 18,458 inhabitants in Northeastern Brazil. To study the prevalence of people with disabilities, estimations performed by health workers were compared with those obtained by researchers who interviewed 15.6% of the total population. To study the agreement of the information, data on 106 people with disabilities completed independently by researchers and health workers were compared to evaluate the degree of agreement for 28 variables analysed. Kappa statistics (κ) were used to calculate the inter-rater agreement.ResultsThe prevalence of disability estimated by community health workers was 3.01 and 2.00% for city A and B, respectively, while the percentages obtained by researchers were 6.72 and 5.65%, respectively, showing an underestimation of prevalence according to community health workers. The Kappa index value obtained for all data analysed (2,589 items excluding losses) was 0.808 (p < 0.01), indicating an almost perfect consistency of information collected by health workers compared to by researchers.ConclusionCommunity health workers collected information with a high degree of reliability, although the identification of the prevalence of disabled individuals was potentially impaired due to the work process.
In this article, we have investigated how researchers use the data provided by the Brazilian Information System of Primary Care . We also searched, for the first time, studies that evaluated the quality and reliability of the information provided by the Primary Care Information System. An integrative review of the literature was performed using the keywords ‘information systems, primary care and SIAB’ on search databases, and 53 of 174 articles were selected. These publications were classified into two large subgroups: those using the Primary Care Information System as ‘data source’ and those that took it as the ‘object of study’. The first group included 35 studies, 18 of which used demographic and social health data records, and nine described data about diseases, specifically hypertension and diabetes. These data were used by researchers for association with health indicators (20%) or comparison with other information systems (17%), sample or population calculus (9%), estimation of prevalence and characterization of the epidemiological profile of a population (26%) or, more generally, to carry out the assessment of health status (29%). The Primary Care Information System as the ‘object of study’ group included 18 works, describing the knowledge and practices of professionals in relation to the information system. These researchers pointed out issues in the process of production and information consolidation, mainly due to the lack of training and supervision of community health workers and bureaucratization of their work process. Although some issues in the quality of data provided by the Primary Care Information System were reported by researchers, these findings were not corroborated by two studies that assessed the reliability of information disclosed by this system. Despite changes in the Brazilian health policies, the issue of data quality in health information systems continues to be a challenge preventing data from being used for decision-making and knowledge production.
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