BackgroundPreeclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide and especially in Latin America. High quality evidence indicates that calcium supplementation during pregnancy significantly reduces the incidence of preeclampsia and its consequences, including severe maternal morbidity and death. Few studies have assessed the implementation of this intervention in clinical practice. The study aimed to assess the proportion of pregnant women who received calcium supplements in Brazilian public antenatal care clinics.MethodsThis cross-sectional study interviewed women waiting for antenatal care visits in 9 public clinics in 4 Brazilian cities in 2010-2012. Trained interviewers used a standardized anonymous questionnaire to collect socio demographic and obstetric data, information on ingestion of dairy products and on prescriptions received during current pregnancy.ResultsA total of 788 valid questionnaires were analyzed. Participants were young (mean age 25.9), mostly multiparous (71.3%) and in the 2nd or 3rd trimesters of pregnancy at the time of interview (87.6%). Only 5.1% (40/788) had received a prescription for calcium supplements. Based on their reported ingestion of dairy products, the mean daily dietary calcium intake of the participants was 210 (+ 265) mg/day and over 90% consumed less than 1 g of calcium/day.ConclusionsDespite good quality evidence indicating the benefits of this practice especially for women with low calcium diets, less than 6% of a sample of women receiving antenatal care in Brazilian public clinics received a prescription for calcium supplements. There is an urgent need to upscale the implementation of this life-saving intervention.

ABSTRACT:Objective: To analyze the expenditure of the Ministry of Health with osteoporosis treatment in the Brazilian Public Health System (SUS) in 2008-2010 triennium and estimate the influence of demographic, regional and disease related variables on average expenditure per procedures performed. Methods: A cross-sectional, descriptive and analytical study based on secondary data from DATASUS related to procedures for the elderly with a diagnosis of osteoporosis and related fractures. For the statistical analysis and multivariate model, Stata 11.0 was used. Results: According to the findings, 3,252,756 procedures related to the osteoporosis treatment among the elderly were carried out in Brazil during the 2008 -2010 period, totalizing R$ 288,986,335.15. The age group that most had procedures was 60 -69 years (46.3%); the population of 80 years or older showed the highest spending per procedure, around R$ 106 million in three years. The women were majority in terms of quantity (95.6%) and expense (76%) of procedures. The average cost per procedure showed a large gap between men and women, nearly 7 times (R$ 480.14 versus R$ 70.85, respectively). The ambulatory care procedures predominated in quantity (96.4%) and the hospital procedures predominated in resources (70.4%). It was found that there is no single standard for groups of procedures when these are analyzed separately. Conclusion: A disaggregated analysis of expenditure by procedures groups extracted from the SUS Management System of the

Resumo Por meio da criação do Sistema Único de Saúde (SUS), os processos de planejamento ganham importância intrínseca para a formulação de políticas públicas de saúde e para subsidiar a tomada de decisões, a implementação de ações e a obtenção de resultados. Como as ferramentas de planejamento são fundamentais para orientar a gestão, é necessário o cuidado nas articulações entre elas, a fim de alcançar a integração dos serviços de saúde, cujo resultado é melhor, mais efetivo e mais barato para o governo. Da mesma forma, processos contínuos de monitoramento e avaliação (M&A) permitem medir e rastrear informações estratégicas, melhorando a qualidade dos sistemas de informação em saúde e dos indicadores de saúde, bem como do desempenho operacional e organizacional. Neste artigo, apresentamos a recente iniciativa de implementação do sistema de M&A na Secretaria de Estado da Saúde do Distrito Federal (SES/DF) e os processos envolvidos em sua qualificação.

RESUMO Este artigo analisa a série histórica de um conjunto de indicadores, de 2002 a 2014, relacionados ao Sistema Único de Saúde do Brasil, embasado na metodologia da Proposta de Avaliação de Desempenho do Sistema de Saúde. Os resultados mostram que houve uma sensível melhoria nos indicadores de dimensão socioeconômica e nos da dimensão condições de saúde. A melhoria dos indicadores de condições de saúde pode estar relacionada ao incremento de suporte financeiro; ao incremento de recursos humanos; ao aumento do acesso às consultas médicas e aos serviços de alta complexidade; e a uma maior disponibilização de horas de profissionais de saúde para a população residente. PALAVRAS-CHAVE

This study examines the health situation in Brazil's Federal District between 2005 and2017. A related set of indicators were selected and compared to those for Brazil 's Midwest ("Centro-Oeste") region and for the country as a whole. First, data are presented on the demographic profile and current organizational structure of the health regions and administrative areas of the Federal District. The results show that infant mortality declined from 18.3% in 2006 to 10.3% (one of the lowest in rates in Brazil) in 2016. AIDS incidence in the Federal District declined 21.3% between 2006 and 2016, a positive result when compared to data for the Midwest region and Brazil. Tuberculosis incidence and mortality rates were among the lowest in Brazil between 2006 and 2016, well below the national average, as were those for Hansen's disease, where both annual incidence and incidence of grade 2 disability decreased significantly between 2007 and 2017. Congenital syphilis in under 1 year-olds has increased in recent years in Brazil and the Midwest, and also in the Federal District, where the rate was 2.56 per 1,000 live births in 2006 and 4.7 per 1,000 live births in in 2016. These data enable managers to identify trends and challenges to be met, and inform decision-making in response to health realities in the Federal District.