Integrated care of childhood disease in Brazil: mothers' response to the recommendations of health workers.
Acta Paediatr
; 94(8): 1116-21, 2005 Aug.
Article
em En
| MEDLINE
| ID: mdl-16188858
ABSTRACT
AIM:
To describe the process of follow-up in primary care facilities where the Integrated Management of Childhood Illness (IMCI) strategy was implemented. IMCI was developed by WHO and UNICEF as an integrated approach to manage sick children under 5 y of age and aims to reduce mortality and morbidity.METHODS:
From August 2001 to February 2002, 229 sick children who had a health condition included in the IMCI case management guidelines were seen in six family healthcare facilities in Brazil. We analysed the care provided to 153 children who were recommended for a 2- or 5-d follow-up visit. Children who did not return were visited and assessed at home.RESULTS:
Only 87 children (56.9%) timely returned for follow-up 70 had improved, eight presented the same health conditions, five were worse and four had a new problem. The main reasons given for not returning for follow-up were the child had improved (35.1%) and other family priorities (47.4%). Home visits showed that, although most children had improved (n=49), some had a new health problem and one child was sick enough to be referred. Prescription of antibiotics was associated with increased probability of returning for a follow-up visit (RR =1.64 [1.22-2.20], p=0.001).CONCLUSION:
Adherence to follow-up was just over 50%, mostly because the condition had already resolved, but some children were still sick and needed intervention. Training on counselling on the recognition of danger signs and when to return for a follow-up visit must be reinforced.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Serviços de Saúde da Criança
/
Prestação Integrada de Cuidados de Saúde
/
Administração de Caso
/
Diretrizes para o Planejamento em Saúde
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Acta Paediatr
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Brasil