Acesso e utilização dos serviços na Estratégia Saúde da Família na perspectiva dos gestores, profissionais e usuários

Abstract

Acesso e utilização dos serviços na Estratégia Saúde da Família na perspectiva dos gestores, profissionais e usuáriosAccess to and use of the services of the family health strategy from the perspective of managers, professionals and usersResumo Utilizaram-se questionários adaptados à realidade brasileira (PCATool) para avaliar acesso e utilização dos serviços, aplicados a 30 gestores, 80 profissionais e amostra aleatória de 882 usuários da Estratégia Saúde da Família (ESF) em São Luís. Diferenças entre as avaliações dos 3 tipos de entrevistados foram identificadas pelo teste de KruskallWallis e pós-teste de Dunn. Usuários tiveram dificuldades no acesso e na utilização dos serviços, também considerados insatisfatórios pelos gestores e profissionais. O acesso foi a dimensão pior avaliada e o não funcionamento das unidades após as 18 horas e finais de semana foram suas principais dificuldades. A avaliação dos gestores e profissionais quase sempre divergiu com a dos usuários, sendo a avaliação dos gestores predominantemente mais favorável. Gratuidade, utilização de serviços preventivos e da ESF antes das consultas especializadas foram bem avaliadas. O funcionamento das unidades precisa se adequar às necessidades dos usuários, principalmente dos trabalhadores. Fortalecer a participação social na gestão local da ESF pode ajudar a identificar essas necessidades, dirimindo divergências entre os atores estudados. Palavras-chave Programa Saúde da Família, Atenção Primária, Avaliação em Saúde Abstract Questionnaires adapted to the Brazilian reality (Primary Care Assessment Tool) to evaluate access to and use of services were distributed to 30 managers, 80 professionals and a random sample of 882 Family Health Strategy (FHS) users in São Luís in the state of Maranhão. The differences between the evaluations of managers, professionals and users were identified by the Kruskal-Wallis test and Dunn's post test. Users faced difficulties in access to and use of the services, which were also considered unsatisfactory by managers and professionals. Access was the dimension with the worst evaluation, and non-functioning of units after 6 p.m. and at weekends were the main difficulties. The evaluations of the managers and professionals were almost always divergent from those of the users, with the evaluation of the managers being more favorable. The fact that the service was free of charge, the use of preventive services and the FHS services before the specialized care were well evaluated. The operation of units should attend users' needs, especially that of the working population. Strengthening social participation in local management of the FHS may assist in identifying these needs, thereby reducing the divergent opinions of the players involved.

Children's health care assistance according to their families: a comparison between models of Primary Care

“…It was observed that some practices could be changed, requiring fewer resources and contributing to achieving the objectives of the APS attributes; for example allowing the user to access the child's records, ensuring a communication interface with the specialized services, informing the family and the community in the care of the subject and opportunizing times for the population to have access to staff via phone. This is aligned with findings from other national research, especially with those conducted in southeastern Brazil (26) . …”

Factors associated with the care of elderly persons with Primary Health Care sensitive conditions

“…The leading role of women in the family group, resulting in greater control of the seeking of health care for their partners, is also relevant. This fact indicates the need to consider the differences of genres and family compositions to ensure a quality of health care that is more coherent with the unique needs of the users 22 .…”

Access to child care services in the Northeast and in the South Regions of Brazil

“…15 In Minas Gerais State, 24.2% of the children attended at the ESF were not regularly controlled with child care. 18 In Maranhão State, the access was the worst dimension assessed among the ESF users, 19 still in the same State, another study identified that 61.4% of the children did not have any child care consultation. 10 The authors attribute these results to the difference in territory with great geographic distances, besides Maranhão State has many small municipalities, where lots of the programmed actions are not available to the population.…”