Análise espacial e temporal da cobertura da triagem auditiva neonatal no Brasil (2008-2015)

Abstract

This article seeks to establish the coverage of neonatal hearing screening in Brazil between January 2008 and June 2015. It is an ecological study that uses the country, through the Urban Articulation Regions, as a base. To calculate the screening coverage percentage, the Live Births Information System, the Outpatient Information System and the Beneficiaries of the National Supplementary Health Agency Information System were used. An exploratory analysis of maps and spatial statistical analysis was conducted using TerraView 4.2.2 software. The coverage of neonatal hearing screening saw an increase of 9.3% to 37.2% during the study period. In 2008-2009 it was observed that the percentage of coverage ranged from 0% to 79.92%, but most areas received coverage from 0% to 20%, though in 2014-2015 coverage ranged from 0% to 171.77%, and there was a visible increase in the percentage of coverage in the country, mainly in the Southern Region. The screening coverage has increased over time, but is still low with an uneven distribution in the territory, which may be explained by local laws and policies and by the existence of different types of auditory health service in the country.

Análise da cobertura da triagem auditiva neonatal no Nordeste brasileiro

“…Throughout this study it became obvious that the NHS goals are not achieved by the SUS. Although an over 75% coverage exists in specific areas, low NHS coverage indices stand out in the northeastern territory, providing confirmation on recent findings in the literature (3,5) . Maranhão, Piauí and Bahia are the states with the largest territorial extent and those which show the highest concentration of coverage deficiency.…”

“…In order for this assistance to reach the population which uses SUS, adjustments and structuring of all public health care network, is fundamental (5) . Throughout this study it became obvious that the NHS goals are not achieved by the SUS.…”

“…However, universal access to SUS users is not yet a reality in Brazil (3,4) . The current national index of universal screening is 37.5% (5) , representing an inferior benchmark than the one recommended and endorsed by the Multiprofessional Committee on Hearing Health (Comitê Multiprofissional em Saúde Auditiva -COMUSA) (6) and by the Joint Committee on Infant Hearing (7) . Among the current challenges in newborn hearing screening (NHS) in the Brazilian scenario, there are the non-compliance to the program and the variability between protocols within different services.…”

“…Spatial analysis can provide a visual evaluation of the distribution pattern of an event through maps. Studies (3,5) using this methodology, show a growth in NHS coverage in all geographic regions of Brazil over time with emphasis on the northeastern region, after the implementation of Federal law n o 12.303/2010. However, the authors observed that this specific region has the least coverage rate when compared to the others.…”

“…As the northeastern region is recognized for its large territorial extent and for its considerable social inequalities (9) , it is possible that SUS users have to deal with difficulties when accessing health services (5) . In order to identify and understand the hindrances that may contribute to these findings, this region requires a meticulous evaluation.…”