Health care for women over 50: programmatic vulnerability in the Family Health Strategy

Abstract

Objective:To assess the health care process for women over 50 at a Family Health Unit based on the concept of programmatic vulnerability. Method: This study is inserted in the fi eld of health care assessments. The framework proposed by Donabedian was used to analyze 90.5% of the 790 records of women registered at the unit. Results: It was observed that none of the women that did not have a diagnosed pathology attended the recommended consultations or underwent the recommended tests. Of the total number of women with hypertension or diabetes, 20.7% were registered in the Hiperdia Programme and less than 1.0% had attended the consultations and undergone the necessary tests. Only 11.9% of the women had had a gynaecological examination, a clinical breast examination and a mammography the year before data collection. Conclusion: It is concluded that women over 50 are in a situation of programmatic vulnerability in terms of the indicators established in this study. Knowledge of this reality can help nurses provide care that is best suited for this group. Keywords: Primary health care. Women's health. Program evaluation. RESUMO Objetivo:Avaliar o processo de atenção prestada a mulheres, a partir dos 50 anos de idade, em Unidade de Saúde da Família, tomando-se como referência o conceito de vulnerabilidade programática. Método: Estudo inserido no campo da avaliação de programas de saúde; utilizou-se o referencial proposto por Donabediam, sendo analisados 90.5% dos 790 prontuários de mulheres matriculadas na Unidade. Resultados: Observou-se que nenhuma mulher sem patologia diagnosticada realizou consultas e exames preconizados. Do total de hipertensas e diabéticas, 20.7% estavam inscritas no Programa Hiperdia e menos de 1.0% tinha realizado as consultas e exames necessários. Apenas 11.9% das mulheres tinham realizado exame ginecológico, exame clínico das mamas e mamografi a, no ano que antecedeu a coleta de dados. Conclusão: Conclui-se que as mulheres com mais de 50 anos estão em situação de vulnerabilidade programática, relacionada aos indicadores defi nidos neste estudo. Logo, conhecer a realidade poderá resultar no atendimento de enfermagem mais adequado para esse grupo. Palavras-chave: Atenção primária à saúde. Saúde da mulher. Avaliação de programas e projetos de saúde. RESUMENObjetivo: evaluar el proceso de atención a las mujeres a partir de los 50 años de edad en la Unidad de Salud de la Familia, tomando como referencia el concepto de vulnerabilidad del programa. Método: Estudio insertado en la evaluación de programas de salud, tuvo Donabediam como referencia, siendo analizados el 90,5% de los 790 registros médicos de mujeres inscritas en la unidad. Fueran creados indicadores de evaluación. Resultados: Ninguna mujer sin patología diagnosticada realizó consultas y exámenes recomendados. De todas las hipertensas y diabéticas, 20,7% estaban inscritas en el Programa Hiperdia y menos del 1,.0% había realizado consultas y exámenes necesarios. Sólo el 11.9% de las mujeres había realizado el examen ginecológico, ...

Mapeamento dos estudos sobre vulnerabilidade em saúde: uma revisão de escopo

“…Apesar disso, a importância do conceito para a saúde coletiva do mundo, pois tem sido discutido em diferentes países, chegando aos cinco continentes, com destaque para a América do Sul (Figueredo & Ayres, 2002;Meneghel et al, 2003;Silva et al, 2007;Bonolo et al, 2008;Maia et al, 2008;Berardinelli et al, 2011;Pimentel et al, 2011;Mussi et al, 2012;Gaviria et al, 2012;Silva & Saldanha, 2012;Bezerra et al, 2012;Santos & Gomes., 2013a;Barros et al, 2013;Sousa et al, 2013;Nicolau et al, 2013;Lima et al, 2013;Bubadué et al, 2013;Taquette et al, 2013;Santos et al, 2013b;Atanázio et al, 2013;Muñoz et al, 2013;Fatini et al, 2014;Carrillo et al, 2014;Barbesí-Fernández et al, 2014;Amendola et al, 2014;Mello et al, 2014;Duarte et al, 2014;Takahashi et al, 2014;Taglietti et al, 2014;Santos et al, 2014;Bringol et al, 2015;Matínez et al, 2015;Santos et al, 2015;Bittencourt et al, 2015;Souza et al, 2015;Silva, Laroca et al, 2015;Pasqual et al, 2015;Bezerra et al, 2015;Zanatta & Motta, 2015;…”

Vulnerability and Primary Health Care: An Integrative Literature Review

“…Nine Brazilian articles 14 , 16 - 20 , 22 , 26 , 27 presented the concept of vulnerability supported by the theoretical framework of Ayres et al 32 , 36 characterized by the interactions between individual, social, and programmatic dimensions and the context where people live.…”

“…In 11 11 - 13 , 18 - 21 , 23 , 24 , 27 , 28 (57.9%) of the 19 articles analyzed, the vulnerability concept was used to assess the response of health policies, programs, and services in relation to individuals or groups identified with some situation of vulnerability, within the context of PHC ( Table 4 ).…”

“…Silva et al 18 used the concept to evaluate the actions of health services and public policies regarding care for children and adolescents in relation to childhood development. Programmatic vulnerability was also addressed in the descriptive epidemiological article by Pasqual et al 19 to assess the care provided to women (over 50 years of age) in a PHC unit. They found worrying aspects of vulnerability associated with the low coverage of health actions recommended by the municipal health policy to address chronic and gynecological diseases in this population.…”

“…They found worrying aspects of vulnerability associated with the low coverage of health actions recommended by the municipal health policy to address chronic and gynecological diseases in this population. Similarly, Costa et al, 19 through an exploratory-descriptive, qualitative study, analyzed the local public health agendas aimed at confronting violence against rural women. The study was based on the recognition that the lack of local public health agendas for policies and programs related to women’s health affected, in particular, rural women in situations of violence, making it difficult to confront the violent situations.…”