Objective: Investigate knowledge and practice of Brazilian public primary and secondary healthcare dentists during COVID-19 pandemic. Methods: An online questionnaire, with socio-demographic and COVID-19 knowledge questions, was utilized. Results: A total of 4,048 dentists working in the Brazilian public primary and secondary healthcare system were investigated. 4,024 (99.41%) believe COVID-19 can be transmitted through dental procedures. It was observed a fair level of COVID-19 symptoms knowledge by these dentists (3.76±1.27 of 6.00), as well as a disbelieve in the actual personal protective equipment (3,382; 83.55%) and biosafety procedures (3,278; 80.98%) utilized as an efficient form of COVID-19 transmission prevention. Country region, performance of social distancing, dental specialty, the believe on personal protective equipment and biosafety preventive measures influenced the likelihood of dentists to perform dental treatment, either elective or urgent, during the COVID-19 pandemic. Conclusion: The need of extra preventive barriers for dental treatment may bring an extra financial stress in the Brazilian public primary and secondary healthcare system, as well as in the patient-dentist relationship, which may have to be reframed. Internationally accepted public guidelines policies regarding dental treatment safety, as well as the technological development of preventive tools, are needed to deal with the challenges brought by COVID-19.
Este artigo está publicado em acesso aberto (Open Access) sob a licença Creative Commons, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho seja corretamente citado. Cuidados com a transmissão: o que levou o Ceará ao epicentro da COVID-19? Transmission care: what led Ceará to be the epicenter of COVID-19? Cuidados de la transmisión: ¿qué ha hecho Ceará para ser el epicentro de la COVID-19?
Background Countries with health systems centered around Primary Health Care tend to achieve better results in maternal and child health, especially in relation to lower morbimortality rates due to preventable causes and health inequalities. However, Primary Health Care is a complex, multifaceted intervention, making it fundamental to understand how its mechanisms address relevant population health outcomes. This paper seeks to identify, classify, evaluate and summarize existing evidence on Primary Health Care mechanisms that influence mortality in children under five, based on a critical realistic epistemology, to inform decision-making. Main body A realist, five-step synthesis was conducted to grasp such mechanisms. As the first step, a theoretical model depicting comprehensive primary health care was developed, based on the analysis of documents from Brazilian regulation on maternal and child health care. The next steps involved an article search, selection and review of relevant sources, extraction and synthesis of evidence, and, finally, the reaching of a consensus on the final theoretical model in step five, based on the evidence encountered in the selected studies. One hundred and thirty-five studies were included, covering research in several countries, exemplifying primary health care as an effective intervention to improve children’s health in different contexts. Additionally, this review revealed that specific interventions, based on selective primary health care, are less powerful, signaling the importance of a systemic approach that acknowledges the interconnection and interaction of Primary Health Care’s multiple components. Furthermore, significant gaps in existing evidence related to specific structuring components of Primary Health Care and how they affect child health, including, but not limited to, planning and organization of services and work processes, or the referral and regulation system. Conclusions We envision that the results of this study may support decision-makers with a deeper understanding of Primary Health Care and how it can be most effective in the improvement of the population’s health. We recommend further studies addressing Primary Health Care as a complex and comprehensive intervention, in different contexts, specifically in relation to the components and indicators of our theoretical model.
Introdução: Políticas públicas são fundamentais para a redução da morbimortalidade na infância. O presente estudo descreve uma evolução política relacionada à Atenção Primária à Saúde da Criança no âmbito da Atenção Primária Saúde (APS) no Brasil, desde a criação do Sistema Único de Saúde (SUS). Metodologia: Revisão narrativa da literatura com base nos principais marcos normativos com influência na Atenção à Saúde da Criança no âmbito da APS, publicados entre 1990 e 2017. Resultados: Foram analisados 31 documentos oficiais, distribuídos numa linha do tempo, classificados em: I) normatização do SUS e da APS; II) orientação aos serviços de saúde materno-infantil no âmbito da APS e III) políticas intersetoriais. Conclusão: A evolução das políticas pensadas no Brasil está marcada para serviços e como soluções da série de direitos sociais e como possibilidades de vistas da vida. Porém, além das desigualdades sociais, desafios no acesso e na qualidade do cuidado na APS se fazem persistentes, com retrocessos são persistentes agravados com a capacidade de trabalhar1 em medidas de austeridade curso desde 206.
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