Efetividade de programa de agentes comunitários na promoção da saúde bucal

Abstract

OBJECTIVE:To assess changes of knowledge and attitudes and health service access and utilization after the implementation of a community health worker program for oral health promotion. METHODS:A capacity building project including learning, support, and supervision activities was developed between July 2003 and August 2004. A study to assess changes was conducted including 36 community health workers and a representative sample of homemaker literate women and mothers aged 25 to 39 years living in 3-to 6-room dwelling in the city of Rio Grande da Serra, southeastern Brazil. Data on oral health knowledge, self-reported practices, and personal skills regarding self-examination, oral hygiene, number of people living in the same household, number of individual and collective toothbrushes, and dental service access and utilization were collected using structured interviews. Mean scores measured pre-and post-intervention program were compared for each group studied using Student's t-test. A 5% signifi cance level was set for the analysis.RESULTS: Statistically significant differences between pre-and postintervention program were seen regarding oral health knowledge among both health workers and women (p<0.05). The number of shared toothbrushes per family decreased. Frequency of toothbrushing and fl ossing increased. Self-assessment of oral hygiene effi cacy increased. Changes in practices and personal skills improved self-effi cacy. Women had more access to services (p<0.000) and used them more regularly (p<0.000). CONCLUSIONS:There were seen signifi cant changes of perception regarding oral health, self-effi cacy, and health service access and utilization. These changes may show that community health workers play a key role in oral health promotion.

The Influence of Community Health Resources on Effectiveness and Sustainability of Community and Lay Health Worker Programs in Lower-Income Countries: A Systematic Review

“…Relationships are described in slightly more detail in eight studies [22,37,43,45,52,53,61,62,64]. For example, Gazi et al dedicate a special section in their article to the interaction between depot holders and the community.…”

“…Eight studies provide actual data on attrition [22,40,43,44,52,61,62,64], which ranges from 10% to 50% or “high”. High attrition—when discussed—is related to life events, a mismatch of expectations, or lack of supervision and monitoring.…”

“…At the low end of attrition, two studies ignore community relationships as possible causes for high retention rates. Frazao et al find 13% attrition in a program promoting oral health [52], while Torpey et al describe a 9% attrition rate [64]. Both studies do note some community engagement during implementation, suggesting the importance of social interactions at family and community levels.…”

Oral health in the agenda of priorities in public health

“…Peres et al 42 described the addition of sugar in syrups and oral drug solutions, with potential damage to children’s oral health. The participation of pediatricians 51 and community health agents 15 in promoting children’s oral health also promoted original research on RSP.…”

Health Policy on the pages of Revista de Saúde Pública

“…The access and use of PHC services stood out in the publications of RSP 15 , 31 , 37 . Other themes also composed the studies on PHC, as Innovative Strategies 73 , humanization practices 68 , integrative practices 3 , 86 , and the performance of Community Health Agents in Oral Health promotion 33 . More recently, important issues were discussed, e.g., the Family Health Support Unit 45 and the institutional support and matrix-based strategies 84 .…”