Objetivo: avaliar a completude e o atraso vacinal das crianças de um centro de educação infantil antes e após uma intervenção educativa com as famílias.Método: estudo do tipo antes e depois, realizado em um centro de educação infantil em São Paulo de fevereiro a abril de 2017. A intervenção consistiu no envio de lembretes e folhetos às famílias sobre a importância da vacinação. A situação vacinal foi verificada através da Caderneta de Saúde da Criança. Foram utilizados os testes qui-quadrado e exato de Fisher.Resultados: participaram do estudo 151 crianças e suas famílias antes e 145 depois. A prevalência da completude vacinal passou de 81,5% para 93,1% após a intervenção (p=0,003). O atraso vacinal foi mais frequente entre crianças menores de dois anos e aquelas do sexo mascuilno.Conclusão: a intervenção contribuiu para o aumento da completude vacinal por meio da educação em saúde das famílias das crianças.

Objective: to analyze the correlation between child development and pregnancy planning and other associated aspects. Method: a cross-sectional study conducted with 125 mother-child dyads, the children aged from 11 to 23 months old and attending daycare centers located in socially disadvantaged areas. Child development according to domains was assessed using the Ages & Stages Questionnaire-BR and pregnancy planning was evaluated through the London Measure of Unplanned Pregnancy. The mothers were interviewed at their homes and non-parametric tests were used for data analysis. Results: 17.6% of the pregnancies were unplanned, 24.8% were planned and 57.6% were ambivalent. Inadequate development in the different domains ranged from 21% to 40% and was not associated with pregnancy planning. However, the “communication” domain was associated with Bolsa Família and the “personal/social” and “communication” domains, with gender; while “personal/social”, “broad motor coordination” and “fine motor coordination” were domains related to the child’s age. Conclusion: no correlation between pregnancy planning and child development was observed; however, the low frequency of planned pregnancies and the high percentages of inadequate child development show the need to invest in the training of health professionals, both for contraceptive care and preconception health and for the promotion of child development, especially in socioeconomically disadvantaged contexts.

La visita domiciliaria realizada por el asistente técnico de atención primaria en salud (ATAPS),  corresponde a la principal actividad fundamental de atención primaria desarrollada en Costa Rica, cuya principal labor es proporcionar información y recomendaciones sobre educación en salud a las personas usuarias. Respecto de lo anterior, el objetivo de esta investigación es determinar los conocimientos y la modificación en los estilos de vidas que las personas realizan posterior a la visita del ATAPS.  El diseño del estudio fue cualitativo, analítico y observacional. Para la recolección de los datos se aplicó entrevistas a profundidad a las personas usuarias visitadas  y se realizó un grupo focal con los ATAPS. Para el análisis de los datos, se estableció categorías de análisis desde la metodología de la teoría fundamentada. Se identificó que las personas usuarias refieren un mayor adquisición de conocimientos cuando se abordó temas como dengue, la vacunación, el lavado de manos, la citología vaginal y una alimentación saludable y un predominio significativo del ama de casa en  la participación de esta actividad, lo que al final limita la transmisibilidad de la información al resto de los integrantes. Con respecto a la modificación de prácticas, la mayoría de las personas expresan cambios en estilos de vida saludable y mayores facilidades para el acceso a los servicios de salud. Se concluye que es importante entender la visita domiciliaria como un medio de aproximación entre las familias y el sistema de salud, que favorezca el acceso a los servicios de salud, mientras se constituye en un instrumento que humaniza la atención de las necesidades.

RESUMENIntroducción. La visita domiciliaria se constituye en la principal estrategia de atención primaria al acercar los servicios de salud a los domicilios y lugares de trabajo de las personas, lo cual permite conocer de primera mano las necesidades de la población. La visita domiciliaria efectuada por el ATAP representa el primer contacto del individuo, familia y comunidad con el sistema de salud, con importantes beneficios tanto a nivel individual como colectivo. La presente investigación responde a la necesidad de identificar los elementos que el programa de visita domiciliaria requiere mejorar, modificar o sustituir con el fin de maximizar la prestación de este servicio. Método. Se diseñó un estudio cualitativo, analítico observacional. Se recolectó los datos mediante revisión bibliográfica, entrevista a informantes claves y grupo focal. El análisis se realizó a partir de la teoría fundamentada. Resultados. Los datos evidenciaron la existencia de elementos a nivel de sistema de salud, programa de visita domiciliaria y figura del ATAP que deben ser revisados, modificados o sustituidos con el fin de que la visita domiciliaria tenga mayores y mejores alcances para la población y el sistema de salud. Conclusión. El programa de visita domiciliaria representa una fortaleza del sistema de salud costarricense al abordar las inequidades en salud. Sin embargo, es imperativa la toma de decisiones e implementación de acciones que promuevan el mejoramiento y aumento de los alcances que tiene la visita domiciliaria en el abordaje de la población a nivel familiar y comunitario.Palabras claves: atención-primaria-de-salud, enfermería, salud, salud-pública, visita-domiciliaria CITED ABSTRACTIntroduction. Home visit is the main strategy of primary care by bringing health services to the homes and workplaces of people, which allows knowing the needs of the population firsthand. Thus, home visit by the ATAP represents the first contact of the individual, family and community with the health system, with significant benefits both individually and collectively. This research responds to the need to identify the elements that the home visiting program needs to improve modify or replace in order to maximize the provision of this service. Method. It is a qualitative, observational analytic study. Data were collected through documentary research, key informant interviews and focus group. The analysis was performed from the grounded theory.Results. The main results showed the existence of elements at the level of the health system, home visiting program and the figure of the ATAP that should be reviewed, modified or replaced to the home visit, thus it has bigger and better results for the population and the health system. Conclusion. The Home Visiting Program is strength of the Costa Rican health system to address health inequities. However, it is imperative to make decisions and implementation of actions that promote the improvement and increased results of the home visit at a family and community level.

No abstract

Objectives: to identify the absence of one or more general child development milestones and by domains, and associated factors. Methods: cross-sectional study with 334 children under three years of age conducted out at Primary Health Care Facilities, São Paulo, Brazil. The dependent variable was the general child development and the fine motor, gross motor, social and psychic domains evaluated using the Developmental Surveillance Instrument of the Brazilian Ministry of Health. Data were obtained by interviewing the mothers and observing children. The chi-square test and logistic regression analyses were used. Results: absence of one or more milestones of general child development was found in 52.1% of children, especially, in the fine motor domain. We found an association between general child development with age (OR = 4.4; CI95%= 2.0-9.9) and the place of stay of the child who does not attend daycare (OR = 3.7; CI95%= 1.3-10.5). Conclusions: the absence of one or more milestones of general child development is high and associated with aspects of the child and the environment. This emphasizes the importance of promoting developmental surveillance in Primary Health Care Facilities among health professionals using the official instrument recommended by the Brazilian Ministry of Health.

Remotely delivered parenting interventions are suitable to promote child well-being and development, in a context of social isolation, as our society faced due to COVID-19. The objective of this systematic review was to assess the effectiveness of remotely delivered parenting interventions for typically developing children on caregiver-child interaction and child development. We carried out a systematic search to find studies from the inception of the database to September 2021 on six electronic databases: MEDLINE, CINAHL, Embase, Scopus, Web of Science Core Collection and Regional Portal Information and Knowledge for Health (BVS), and gray literature. Eligible study designs were experimental and quasiexperimental studies. We included parenting interventions as long as they were remotely delivered and focused on typically developing children. Two outcomes were considered: caregiver-child interaction and child development. Three randomized controlled trials (RCT) and one quasi-experimental study met the inclusion criteria. Results from two RCT revealed positive, small-to-medium effects on child development. One study showed that the new intervention had a not inferior effect compared to the results achieved by the traditional support. Children who participated in the quasi-experimental study showed significant elevations in language ability. One study reported positive caregiver-child interaction results. There is insufficient evidence to draw definitive conclusions regarding the effectiveness of remotely delivered parenting interventions on child development due to the heterogeneity of participant profiles, mode of delivery, and assessment tools. The results suggest the need to develop future methodologically rigorous studies assessing the effectiveness of remotely delivered parenting interventions for typically developing children on caregiver-child interaction and child development. KeywordsChild development • Parent-child interaction • Remotely delivered • COVID-19 virus • Systematic review Highlights • Families need support and motivation to promote the well-being and development of their children.

Introducción. La inyección intramuscular es una técnica que causa dolor e incomodidad a las personas. Con el objetivo de determinar la zona de punción menos dolorosa para la administración de medicamentos intramusculares en glúteo, se realizó una revisión de literatura en busca de la evidencia de mayor calidad. Método. Se empleó el método propuesto por el enfoque de la Práctica Clínica de Enfermería Basada en la Evidencia. Se recopiló estudios de EBSCOhost, Google, Google Académico, Cochrane Library y PubMed. Se aplicó los filtros propuestos para la selección: se sometió los dos artículos seleccionados a lectura crítica mediante la plataforma FLC 2.0 con la cual se valoró la calidad de los estudios. El riesgo de sesgo se valoró con The Cochrane Collaboration's tool for assessing risk of bias. A través del sistema de clasificación GRADE se determinó la calidad de la evidencia y la fuerza de la recomendación de la intervención.Resultado. Los artículos incluidos en el estudio respondieron parcialmente a la pregunta clínica planteada. La percepción de dolor durante la administración de inyectables en el sitio ventroglúteo es menor que en el dorsoglúteo, los hallazgos tuvieron un nivel de evidencia moderado y la fuerza de recomendación fue 1B.Conclusión. No hay evidencia contundente para preferir la elección del sitio ventroglúteo sobre el dorsoglúteo para disminuir el dolor asociado a la administración intramuscular de analgésicos antiinflamatorios, aunque el primer sitio posee mayores ventajas en comparación con el segundo.