Acesso ao cuidado à saúde da criança em serviços de atenção primária

Abstract

It was conducted a qualitative study based on the methodological framework of dialectical hermeneutics, aiming to identify the attribute access from primary care to solve the health problems of children under one year old from the reports of parents and caregivers. Sixteen caregivers of children were involved, all of them seen in the emergency units of Cascavel-PR, in 2010. Four thematic categories were recognized: Family counselling in seeking health care for the child; Absence of reception on the first contact; Presence of risk classification to the child´s health attention; Barriers that block the access to health care. It was conclude that, families showed difficulties to reach the solution for their children´s health, because of the lack of access to primary care services.

Accessibility of children with special health needs to the health care network

“…In the results, the perception of family caregivers regarding the role of PHC was not in line with the guidelines of the network, whose objective is to strengthen the actions of primary care services as a care coordinator, aiming to guarantee the continuous care and the strengthening of bonds between professionals, families and health institutions (11) . However, similar results have also been found in other studies, emphasizing that emergency services and tertiary services are preferred at the expense of primary level services, even to address the demands of PHC (8,12,28) . According to a Chilean study, when the attention to the health of CSHCN is focused on secondary and tertiary care services financial costs increase, the continuity of care is impaired and the accessibility to the benefits available in primary health care is restricted (30) .…”

“…Another relevant aspect refers to geographical barriers; thus, when the specialized service is distant, service functionality is impaired (12) . A systematic review of 61 articles on barriers to access to health services has shown that the coverage of health care is adversely affected by transport-related barriers, particularly for lower-income households (29) .…”

“…Failure to follow-up these children via home visits was also identified. Furthermore, the non-follow-up of these children by Family Health Strategy teams -home visit -denotes the non-fulfillment of one of the attributes of PHC, i.e., the longitudinal provision of care (12) , focusing the responsibility for the care and follow-up of children in specialized and emergency services. However, home visit is a work instrument capable of aggregating actions for health promotion, disease prevention and health surveillance in PHC (31)(32) .…”

“…Accessibility, in this study, is related to the use of the service, regardless of the health problem that affects people or the number of times they seek services. First-contact care is inserted as an attribution of PHC (12) . Accessibility thus refers to the use of a set of services in face of each new problem or new episode that causes the population to seek health care (11) .…”

Influence of multiprofessional work on the production of care and access to primary health care

“…Risk classification is an important tool identified by the family groups to optimize priority access 18 . However, as evidenced, the service is limited to a sign of severity and excludes from attendance children with other signs that would also require immediate care.…”