Facility infrastructure of primary health services regarding tuberculosis control: a countrywide cross-sectional study.

BACKGROUND: Tuberculosis (TB) is still a major public health problem in many countries, including Brazil. Primary health care (PHC) services are a set of important services with infrastructure and resources to diagnose, treat, and cure several diseases, including the TB. AIM: The aim of this study is to analyse aspects of the facility infrastructure of Brazilian PHC, regarding the control and treatment of TB from a countrywide perspective. METHODS: This is a cross-sectional study based on PHC services. Data were collected from 38,812 health centres and were assessed by means of the National Program for Improving Access and Quality Primary Care. The outcome was obtained by the presence and availability of the following infrastructure items: air circulation in the consultation room, refrigerator, individual protective equipment, plastic jar for sputum examination, and TB notification form of the primary care information system. Poisson regression was used to calculate the prevalence ratio. FINDINGS: Of the 38,812 evaluated centres, only 1628 (4.2%) presented a positive result regarding the outcome. Primary health centres, among all types of centres, presented the highest quality of facility infrastructure for TB control. Centres with large workloads, as well as those that presented a list of offered services and a welcoming consulting room, also presented the highest quality infrastructure. The present study shows that major improvements should be made to the infrastructure to reach a satisfactory TB control in Brazil.

Avaliação de estrutura e processo na atenção em Diabetes mellitus / Evaluation of structure and process in care in Diabetes mellitus

Avaliar a atenção à saúde aos pacientes com Diabetes mellitus tipo 2 a partir dos recursos humanos, registros de profissionais e de atividades técnicas em um Centro de Saúde Escola. Metodologia: Estudo avaliativo quantitativo, descritivo por meio de observação e análise de 150 pacientes com DM em um Centro de Saúde Escola no interior paulista. Resultados: A estrutura física segue a maioria das exigências da Agência Nacional de Vigilância Sanitária, os recursos materiais atendem as necessidades em relação às quantidades e qualidade. Em 145 (96.6%) prontuários haviam registros médicos oque aponta a organização do trabalho centrada no modelo biomédico. O registro das medidas antropométricas foi considerado baixo, sendo que em apenas 4 (2.6%) havia a medida da circunferência abdominal.Apenas 5 (3.3%) dos pacientes tiveram consulta com o enfermeiro. Essas consultas foram pontuais enfatizando orientações sobre uso dos medicamentos e aparentemente não se constitui em rotina no serviço. Conclusão: Considerou-se a estrutura do serviço como apropriada, no entanto o processo é um fator a ser revisto pela equipe de saúde...

Evaluate health care to patients with Diabetes mellitus type 2 by means of human resources, records of professional and technical activities in a School Health Center. Methodology: A quantitative, descriptive evaluative study through observation and analysis of 150 patients with DM at a School Health Center in São Paulo. Results: The physical structure follows most of the requirements of the National Health Surveillance Agency; the material resources cater the needs in the quantities and quality. The medical records 145 (96.6%) indicates that work organization was focused on the biomedical model. The registration of anthropometric measures was considered low, and in only 4 (2.6%) hadthe measure of waist circumference. Only 5 (3.3%) patients had consultation with the nurse. These consultations were punctual and highlighting specific guidelines on use of medications and there seems to be not in the service routine. Conclusion: We considered the structure of the service as appropriatebut the process is a factor to be reviewed by the health team...

Determinantes da organização da atenção em diabetes mellitus mellitusna satisfação do usuário / Determinants of the organization of diabetes mellitus care in usersatisfaction

O objetivo do estudo foi analisar os determinantes da satisfação do usuário com Diabetes Mellitus (DM) sobre o atendimento no ambulatório de especialidades de um Centro de Saúde Escola. O estudo transversal com abordagem qualitativa foi desenvolvido no ambulatório de especialidades com 20 usuários com diagnóstico de DM. Foram aplicadas entrevistas semiestruturadas por meio de um roteiro norteador. Utilizou-se software Atlas ti 7.0 para auxílio na codificação das falas e técnica de Análise de Conteúdo para análise dos dados. Como resultado, observou-se que os temas mais evidenciados estão relacionados à acessibilidade organizacional e à relação entre usuário, equipe e serviço na perspectiva da longitudinalidade. Observou-se a identificação do ambulatório de especialidade como fonte regular de cuidado e a insatisfação no que se refere à acessibilidade ao serviço...

The objective of the study was analyze user satisfaction determinants of patients with Diabetes Mellitus (DM) regarding the outpatient clinic specialties at the Health Centre of the School. Qualitative crosssectional study was carried out in outpatient specialty with 20 users with diagnosis of DM. We adopted the method of semi-structured interview using a scripting guide. We used Atlas it software 7.0 to aid in the decoding of speech, and analyzed it by content analysis. The empirical material encoded enabled to observe that the most evident themes are related to organizational accessibility and the relationship between user and service staff in perspective of longitudinality. It was observed the outpatient identifying clinic specialties as a regular source of care and dissatisfaction with regard to service accessibility...