Population-based health surveys are important tools for identifying disease determinants, especially in regions with widely dispersed populations and low health system coverage. The aim of this study was to describe the principal methodological aspects and to describe the socioeconomic, demographic, and health characteristics of the riverine populations of Coari, Amazonas State, Brazil. This was a population-based cross-sectional study in river-dwelling communities in the rural area of Coari, from April to July 2015. The probabilistic cluster sample consisted of 492 individuals. The results showed that the majority of the river-dwellers were females (53%), had up to 9 years of schooling (68.5%), and earned a monthly family income equivalent to one-third the minimum wage. The health problems reported in the previous 30 days featured conditions involving pain (45.2%). The main healthcare resources were allopathic medicines (70.3%), exceeding herbal remedies (44.3%). The river-dwellers travel an average of 60.4km and take some 4.2 hours to reach the urban area of Coari. The riverine population generally presents low economic status and limited access to the urban area. Health problems are mostly solved with allopathic medicines. Geographic characteristics, as barriers to access to health services and to improvements in living conditions for the riverine population, can limit the collection of epidemiological data on these populations.

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This study focuses on access to prenatal care and quality of care in the Family Health Strategy in Brazil as a whole and in the North region, through evaluation of infrastructure characteristics in the health units, management, and supply of care provided by the teams, from the perspective of regional and state inequalities. A cross-sectional evaluative and normative study was performed, drawing on the external evaluation component of the second round of the Program for Improvement of Access and Quality of Primary Care, in 2013-2014. The results revealed the inadequacy of the primary healthcare network's infrastructure for prenatal care, low adequacy of clinical actions for quality of care, and the teams' low management capacity to guarantee access and quality of care. In the distribution according to geopolitical regions, the findings pertaining to the units' infrastructure indicate a direct relationship between the infrastructure's adequacy and social contexts with higher municipal human development indices and income. For the clinical actions in patient care, the teams in all the regions scored low on adequacy, with slightly better results in the North and South regions of the country. There were important differences between the states of the North, and the states with higher mean income and human development scored higher on adequacy. The results indicate important organizational difficulties in both access and quality of care provided by the health teams, in addition to visible insufficiency in management activities aimed to improve access and quality of prenatal care.

Background: The ways of life in the Amazon are diverse and not widely known. In addition, social inequities, large geographic distances and inadequate health care network noticeably limit access to health services in rural areas. Over the last decades, Brazilian health authorities have implemented fluvial mobile units (FMU) as an alternative to increase access and healthcare coverage. The aim of the study was to identify the strategies of access and utilization of primary health care (PHC) services by assessing the strengths and limitations of the healthcare model offered by the FMU to reduce barriers to services and ensure the right to healthcare. Methods: Qualitative and ethnographic research involving participant observation and semi-structured interviews. Data collection consisted of interviews with users and health professionals and the observation of service organization and healthcare delivered by the FMU, in addition to the therapeutic itineraries that determine demand, access and interaction of users with healthcare services. Results: Primary care is offered by the monthly locomotion of the FMU that serves approximately 20 rural riverside communities. The effectiveness of the actions of the FMU proved to be adequate for conditions such as antenatal care for low-risk pregnancy, which require periodic consultations. However, conditions that require continued attention are not adequately met through the organization of care established in the FMU. The underutilization of the workforce of community health workers and disarrangement between their tasks and those of the rest of the multi-professional team are some of the reasons pointed out, making the healthcare continuity unfeasible within the intervals between the trips of the FMU. From the users' perspective, although the presence of the FMU provides healthcare coverage, the financial burden generated by the pursuit for services persists, since the dispersed housing pattern requires the locomotion of users to reach the mobile unit services as well as for specialized care in the urban centers.

Telefone: (092) RESUMO: O reconhecimento oficial da fitoterapia na odontologia no Brasil veio acompanhado de diversas lacunas na pesquisa científica e na utilização de plantas medicinais, especificamente para espécies vegetais com aplicação nas doenças da cavidade oral. O estado do Amazonas, especificamente a cidade de Manaus, não possui um diagnóstico da aplicabilidade de plantas medicinais nos serviços de atenção Odontológica. Esse estudo propôs realizar um estudo do tipo quali-quantitativo, descritivo e exploratório visando o levantamento da comercialização de plantas medicinais e o estudo etnobotânico para identificação das principais plantas medicinais indicadas e utilizadas nas patologias orais nos atendimentos odontológicos ambulatoriais na cidade de Manaus. Foram entrevistados 197 usuários do serviço odontológico, 150 Cirurgiões-Dentistas, e 47 comerciantes credenciados na prefeitura Municipal de Manaus. A amostragem foi realizada por acessibilidade ou conveniência para os Cirurgiões-Dentistas, enquanto os usuários foram selecionados através de amostragem aleatória simples, e os comerciantes de plantas medicinais foram entrevistados em sua totalidade. Os resultados demonstraram a existência de comercialização de plantas medicinais para patologias orais, destacando-se as seguintes espécies: Pedra ume cãa (Aulomyrcia sphareocarpa), Crajiru (Arrabidae chica), além da planta, sem identificação botânica, conhecida popularmente como Sara tudo. Entre os Cirurgiões-Dentistas e entre os pacientes, apenas 8% e 7,61%, respectivamente, utilizaram plantas medicinais para alterações patológicas orais. Os autores concluíram que as plantas medicinais comercializadas na cidade de Manaus são utilizadas de maneira empírica e que, apesar da Política Nacional de Práticas Integrativas e Complementares (PNPIC), novas políticas públicas de saúde devem inserir plantas medicinais e fitoterápicos de uso oral na rede pública de saúde na cidade de Manaus. Palavras-chave: Odontologia, Fitoterápicos, EtnobotânicoABSTRACT: Phytotherapics in Odontology: ethnobotanical study in Manaus. The official recognition of herbal medicine in dentistry in Brazil was accompanied by several gaps in scientific research and the use of medicinal plants, specifically for plant species applied to diseases of the oral cavity. The state of Amazonas, specifically the city of Manaus, does not have a diagnosis of applicability of medicinal plants in Dental care services. This research intended to conduct a qualitative and quantitative-type, descriptive and exploratory study in order to conduct a survey on the commercialization of medicinal plants and an ethnobotanical study to identify the main medicinal plants indicated and used in oral pathologies in outpatient dental care in the city of Manaus. We interviewed 197 users of dental services, 150 dentists, and 47 accredited traders in the Municipality of Manaus. The sampling was performed by accessibility or convenience for surgeon-dentists, while users were selected through simple random sampling, and all ...