Health follow-up of children in poverty situation: between the routine and eventuality of daily care

Mello, Débora Falleiros de; Lima, Regina Aparecida Garcia de; Scochi, Carmen Gracinda Silvan

doi:10.1590/s0104-11692007000700017

Cited by 15 publications

(19 citation statements)

References 8 publications

(10 reference statements)

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“…Melo et al 34 identified from observation of healthcare workers that mothers take their children for pediatric monitoring at Family Health Units only when they are suffering from some health problem, which may explain the absence of some of the families that was seen during the present study.…”

Section: Discussionmentioning

confidence: 75%

The effect of poverty on developmental screening scores among infants

Paiva

Lima

et al. 2010

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Child development is negatively influenced by multiple risk factors associated with poverty, thus indicating the importance of identifying the most vulnerable groups within populations that are apparently homogeneous regarding their state of socioeconomic deprivation. This study aimed to identify different levels of poverty in a population of low socioeconomic condition and to ascertain their influence on infants' neuropsychomotor development. DESIGN AND SETTING:Cross-sectional study conducted at four Family Health Units in the Health District IV in the city of Recife, Brazil. METHODS:The sample comprised 136 infants aged 9 to 12 months, which represented 86% of all the infants in this age group, registered at the units studied. Socioeconomic status was assessed through a specific index and child development through the Bayley III screening test.RESULTS: Around 20% of the families were in the lowest quartile of the socioeconomic level index and these presented the highest frequency of infants with suspected delay in receptive communication. Maternal and paternal unemployment negatively influenced receptive communication and cognition, respectively. Not possessing a cell phone (a reflection of low socioeconomic status) was associated with worse cognitive performance and gross motricity. Male infants showed a higher frequency of suspected delay in receptive communication. CONCLUSIONS:Infants of more precarious socioeconomic status more frequently present suspected developmental delay. Development monitoring and intervention programs should be encouraged for this subgroup, thereby providing these children with a better chance of becoming productive citizens in the future.RESUMO CONTEXTO E OBJETIVO: O desenvolvimento infantil é influenciado negativamente por múltiplos fatores de risco associados à pobreza, tornando relevante a identificação de grupos mais vulneráveis numa população aparentemente homogênea quanto à sua condição de privação socioeconômica.O objetivo deste estudo foi identificar diferentes níveis de pobreza em uma população de baixa condição socioeconômica e verificar sua influência no desenvolvimento neuropsicomotor de lactentes. DESENHO E LOCAL DO ESTUDO:Estudo transversal realizado em quatro Unidades de Saúde da Família do Distrito Sanitário IV da cidade do Recife, Brasil.MÉTODOS: Amostra constou de 136 crianças entre 9 e 12 meses de vida, representando 86% dos lactentes cadastrados nesta faixa etária nas unidades estudadas. A condição socioeconômica foi avaliada segundo um índice de medição específico e o desenvolvimento através do teste de triagem da Bayley III. RESULTADOS: Cerca de 20% das famílias encontravam-se no quartil inferior do índice do nível socioeconômico, e apresentaram frequência mais elevada de crianças com suspeita de atraso na comunicação receptiva. O desemprego materno e paterno influenciou negativamente a comunicação receptiva e cognição, respectivamente. Não possuir telefone celular, refletindo o baixo nível socioeconômico, esteve associado a um p...

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Section: Discussionmentioning

confidence: 75%

The effect of poverty on developmental screening scores among infants

Paiva

Lima

et al. 2010

Sao Paulo Med. J.

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“…Apesar do avanço em pesquisas que objetivam a análise da qualidade do serviço de saúde, ainda há poucos estudos com a população infantil voltados para a análise da associação das condições socioambientais que afetam negativamente a utilização do serviço de saúde de puericultura [10][11][12][13][14][15] . Os resultados gerais apontam baixa frequência no atendimento de puericultura em populações com condições socioeconômicas desfavoráveis, sendo que a doença é o motivo principal da busca pelo serviço.…”

Section: Introductionunclassified

Frequency of public child care service use and associated factors

2010

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Objective: Assess the maternal socio-demographic factors associated with the frequency of use of child care services by low income families. Methods:Cross-sectional analysis of 393 children between 12 and 16 months old who participated in a randomized field trial during their first year of life in a program of nutritional intervention. The study began in the Brazilian Unified Health System (Sistema Único de Saúde, SUS) of the maternity hospital in the city of São Leopoldo, state of Rio Grande do Sul, Brazil. Children were examined regarding child care follow-up and vaccination schedule by checking the immunization chart. Data were analyzed using statistical tests Pearson's chi square and prevalence ratio (PR) with respective 95% confidence interval. Results:The frequency of children who were not continuously taken to the child care service was 53.2%. Multivariate analysis suggests that the factors associated with the lack of continuous use of the service were: mother's educational level ≤ 8 years (PR 1.32 CI95% 1.02-1.71), nonnuclear family structure (PR 1.32 CI95% 1.10-1.59) and not being an only child (PR 1.38 CI95% 1.10-1.72). The reasons for lack of follow-up, according to the mothers were: the fact that they thought it unnecessary for 66.2%, problems with the service for 21.7%, difficulties related to their jobs for 6.05%, and other reasons for 6.05%. Conclusion:The high frequency of children who were not taken to the child health care service for follow-up is associated with low maternal educational level and family structure, as well as the perception that followup visits are not necessary when the child does not have a disease. J Pediatr (Rio J) ResumoObjetivo: Avaliar os fatores sociodemográficos associados à frequência da utilização do serviço de puericultura por famílias de baixo nível socioeconômico.Métodos: Análise transversal de 393 crianças, com idades entre 12 e 16 meses, que participaram de um ensaio de campo randomizado no primeiro ano de vida em um programa de intervenção nutricional. O estudo iniciou nos setores de atendimento do Sistema Único de Saúde da maternidade da cidade de São Leopoldo (RS). As crianças foram avaliadas quanto ao acompanhamento na puericultura e calendário de vacinação. Para análise dos dados utilizou-se teste qui-quadrado de Pearson e razão de prevalência (RP) com respectivo intervalo de confiança de 95% (IC95%).Resultados: A frequência de crianças que não foram levadas regularmente foi de 53,2%. A análise multivariada sugere que os fatores associados à ausência de utilização regular do serviço foram: escolaridade materna ≤ 8 anos (RP 1,32; IC95% 1,02-1,71), estrutura familiar não nuclear (RP 1,32; IC95% 1,10-1,59) e não ser filho único (RP 1,38; IC95% 1,10-1,72). Os motivos relatados para o não acompanhamento da criança na puericultura foram: 66,2% consideraram desnecessário, 21,7% referiram insatisfação com o serviço, 6,05% impossibilidade devido ao emprego e 6,05% outros motivos. Conclusão:A elevada frequência de crianças que não são levadas para acompanham...

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“…Immunization is a preventive action the health service offers to the population and it is essential to expand nursing activities directed at the child and family, implying that they should be close in the health-disease process and care, because the child and the family need several kinds of health care, whatever the fragility or harm is (22) .…”

Section: Think It's a Mistake I Don't Know What To Think Becausementioning

confidence: 99%

Experiences of families in the immunization of Brazilian children under two years old

Figueiredo

Pina

Tonete

et al. 2011

Rev. Latino-Am. Enfermagem

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This study aimed to describe the experience of families in the immunization of children under two years. Descriptive study with qualitative data analysis. Twenty-two subjects participated in unstructured interviews. Results were grouped into three categories: Practical knowledge on children's immunization; Responsibility and compulsory immunization of children; Increasing the scope of children's immunization practices. The findings highlight factors that increase vaccination rates: experience and personal fulfillment in maternity, fear of getting ill, recognizing it as good care, access, schedule flexibility, dissemination, immunization record card, immunization campaigns and availability of vaccines, and factors that increase non-vaccination rates: parent's inexperience, refusal to apply simultaneous immunization, fragmented care, absence of dialog, discrimination, false counter-indications and compulsoriness. Immunization centered on compliance with the calendar or in authoritarian situations is not tied to family care. The bond between health care professionals and families needs to be strengthened to increase the participation in child health protection and promotion measures. Experiencias de familias en la inmunización de niños brasileños menores de dos añosEl objetivo fue describir las experiencias de familias sobre inmunización de niños menores de dos años. Estudio de naturaleza descriptiva, con análisis cualitativa de los datos, entrevistas no estructuradas con 22 sujetos. Resultados agrupados en: Conocimientos prácticos sobre inmunización, Responsabilidad y obligatoriedad en la inmunización, Ampliación de la práctica de inmunización. Fueron destacados elementos que fortalecen la inmunización: experiencia y realización personal en el papel de ser madre, temor a enfermarse, reconocimiento como un buen cuidado, acceso, flexibilidad del horario, divulgación, cartón de vacunas, campañas de vacunación y disponibilidad de vacunas, y elementos de la no-inmunización: inexperiencia de los padres, recusa de aplicaciones simultáneas de vacunas, asistencia fragmentada, ausencia de diálogo, discriminación, falsas contra-indicaciones y obligatoriedad. La inmunización centrada en el cumplimiento del calendario vacunal o en situaciones autoritarias está desvinculada del cuidado familiar.El vínculo con las familias precisa ser fortalecido para ampliación de la adhesión a las medidas de protección y promoción de la salud del niño.Descriptores: Salud del Niño; Inmunización; Atención Primaria de Salud.

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Health follow-up of children in poverty situation: between the routine and eventuality of daily care

Cited by 15 publications

References 8 publications

The effect of poverty on developmental screening scores among infants

The effect of poverty on developmental screening scores among infants

Frequency of public child care service use and associated factors

Experiences of families in the immunization of Brazilian children under two years old

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