No abstract

Knowing the vital statistics of a population is fundamental in controlling morbidity and mortality and improving living conditions. In Brazil, however, the available health information systems do not provide reliable vital statistics. This study was carried out in Quixadá, Icapuí, and Jucás, three municipalities in the state of Ceará that had good coverage by primary health care services. The study used an epidemiological instrument known as a "verbal autopsy" and investigated 215 (90%) of the 237 deaths of children younger than 1 year identified in 1993 and 1994 in the three communities. We investigated socioeconomic characteristics; sanitary conditions; nutritional status; the course of illness, health care, and death; the cause of death; and the operation of the national mortality information system and of the community health agents system. According to the verbal autopsies, diarrhea was the cause of death in 39% of the cases, followed by premature birth (17%), and acute respiratory infections (10%). Even though 79% of the families had sought formal health care services during the child's illness, 49% of the infants had died at home. This suggests limited effectiveness in the identification and treatment of sick infants. In 84% of the cases the family sought help from folk healers. Although community health agents reported 78% of the deaths, only 29% of the families had sought help from the agents during the children's illnesses. In terms of the statistical agreement between the information on the cause of death provided by community health agents and by the verbal autopsies, the agreement was good for diarrhea, intermediate for other causes, and low for acute respiratory infections. Making verbal autopsy a routine part of primary health care services in Ceará would provide invaluable information for local health care teams and would raise a critical consciousness fostering a reduction in infant mortality.

Objective: to build an integral care line for workers with repetitive strain injuries. Methods: action-research with actions of the care line were developed in four workshops with the participation of 32 professionals, managers and users of primary, secondary and tertiary healthcare. Actions which obtained 80.0% agreement of the participants were included in the care line. Results: the Family Health Strategy was defined as the main gateway, coordinating and organizing the care through surveillance of workers' health in its territory. As a secondary gateway, in urgent cases, referral hospitals were cited. The specialized care network was responsible for diagnosis, treatment and rehabilitation of referred cases. Conclusion: the care line developed by the action-research allowed the visualization of a flow to attention to workers and can be a reference for other municipalities. Descriptors: Occupational Health; Health Services; Cumulative Trauma Disorders. Objetivo: construir uma linha de cuidado integral para o trabalhador com lesões por esforços repetitivos. Métodos: pesquisa-ação com ações da linha de cuidado foram construídas em quatro oficinas, com a participação de 32 profissionais, gestores e usuários da atenção primária, secundária e terciária. Foram incluídas na linha de cuidado as ações que obtiveram 80,0% de concordância dos participantes. Resultados: a Estratégia Saúde da Família foi definida como principal porta de entrada, coordenadora e ordenadora do cuidado e pela vigilância à saúde do trabalhador no seu território. Como porta de entrada secundária, em casos de urgência, ficaram hospitais de referência. A rede de atenção especializada ficou responsável pelo diagnóstico, tratamento e reabilitação de casos referenciados. Conclusão: a linha de cuidado construída pela pesquisa-ação permitiu a visualização de um fluxo para atenção aos trabalhadores e pode ser referência para outros municípios.

This is a cross-sectional study with a cohort of children born from 1990 to 1994, home interviews, clinical evaluation and lab exams. The structure for the development of the research was elaborated based on the model of attention towards the health of Family Health Strategy. In this report, the results of such home interviews shall be presented in regards to socio-demographic and environmental conditions in general, with a more detailed analysis of life styles, educational levels, child labor, nutrition and the use of health services by children.

ResumoConstruir efetivamente um sistema público de saúde universal, integral e equânime, de acordo com o que foi definido na Constituinte para o SUS, exige dos gestores e trabalhadores grandes esforços no campo da organização dos serviços e da