Data quality and arbovirus infection associated factors in pregnant and non-pregnant women of childbearing age in Brazil: A surveillance database analysis.

The dengue surveillance system in Brazil has registered changes in the disease's morbidity and mortality profile over successive epidemics. Vulnerable groups, such as pregnant women, have been particularly hard hit. This study assessed the quality of notifications of dengue cases among pregnant women and non-pregnant women of childbearing age in Brazil, in addition to discussing the factors associated with arbovirus infection in the group of pregnant women. We carried out a retrospective study of cases registered in the national arbovirus surveillance system between 2007 and 2017. The indicator for assessing quality was incompleteness. Logistic regression was used to analyze the association between dengue during pregnancy and sociodemographic, epidemiological, clinical, and laboratory variables. The incompleteness of the data in the notification form for dengue cases in women of childbearing age and pregnant women indicates a significant loss of information. Dengue was shown to be positively associated with Social Determinants of Health in both groups, with more severe effects among pregnant women. The incompleteness of the data can limit the quality of information from the notification system and the national assessment of the situation of the disease in women of childbearing age and pregnant women.

Nutritional status coverage trend registered in the SISVAN web in seven municipalities of the Zona Da Mata Mineira, Brazil, from 2008 to 2017, and its association with socio-economic, demographic and organisation of health system variables.

We analysed the coverage trend of the evaluation of the nutritional status of users of public health services registered in the Food and Nutrition Surveillance System (SISVAN) between 2008 and 2017 in seven municipalities and verified the association of the coverage trend with the socio-economic, demographic and organisational aspects of health system variables. It is an ecological time-series study performed with secondary data extracted from health information systems. Descriptive statistics, linear regression model and repeated measures analysis were performed. The coverage of evaluation of nutritional status was low over the period. Five municipalities showed a tendency to increase coverage, although small, while two remained stable. The highest annual variation in coverage increase was concentrated in the group of pregnant women and the lowest in adolescents and older adults. There was a downward trend in follow-ups from the Bolsa Family Programme and a trend towards increased follow-ups from SUS Primary Care (e-SUS AB). SISVAN coverage was positively associated with the proportion of rural population (P ≤ 0·001) and coverage of community health agents (P < 0·001); and negatively associated with total population (P < 0·001), demographic density (P = 0·006) and gross domestic product per capita (P = 0·008). Despite the tendency to increase coverage in some municipalities, SISVAN still presents low coverage of nutritional status assessment, which compromises population monitoring. Knowing the factors that influence the coverage can subsidise the elaboration of strategies for its expansion.

[Reflective portfolio: a proposal for teaching and learning geared on competencies]. / Portfólio reflexivo: uma proposta de ensino e aprendizagem orientada por competências.

This article seeks to analyze the experience of collective construction of portfolios as a teaching-learning method in the discipline of Health Policy, identifying the competencies developed by students. Qualitative research, whose collection and data processing were conducted by means of documental and thematic analysis of 34 portfolios. The "Learning to be" and "Learning to live and work together" competencies were considered according to the proposals of the UNESCO report for Education. The training of critical-reflexive individuals, provided by the portfolio, was particularly observed when students reported the transformation of the negative views that they had about the health care system - an inefficient and precarious policy - to a positive vision - policy which deals with the principles of equity, integrity and universality. This process of critical transformation is the result of the practice and use of communication skills, information management (search, selection, analysis and evaluation of information), leadership, cooperation and human relationships (teamwork, ethics and recognition of diversity), and personal competencies (time management, responsibility and planning), namely important skills in the training of professionals committed to the national health policy.

[Learning portfolios as a tool for reflection: building competencies for work in the Unified Health System]. / Portfólios reflexivos: construindo competências para o trabalho no Sistema Único de Saúde.

OBJECTIVE: To assess the innovative experience of competency education through reflective portfolios for the training of professionals who will work in the Brazilian Unified Health System (SUS). METHODS: A qualitative research approach was employed. Documentary analysis was carried out covering 25 portfolios produced in the years 2008, 2009, and 2010 in the health policy course at the Federal University of Viçosa, Minas Gerais, Brazil, in order to verify if this method allowed the acquisition of the competencies: learning to be (acting with autonomy, good judgment, personal responsibility); learning to know (assimilating general and specific scientific and cultural knowledge, which will be complemented and updated in the course of life); learning to do (acquiring procedures that will be useful for facing life and work difficulties); and learning to live and work together (better understanding of others, the world, and their inter-relationships). RESULTS: Students became involved with the proposed activities, especially the management of information (active search, selection, critical analyses, reviews, syntheses, and evaluation of information). There was a gradual opening to critical thinking, integrating new dimensions to the initial vision held by students on the SUS, which moved from a focus on disease and healing to a focus on health and prevention, and from a vision of SUS as a theoretical model towards a view of SUS as a feasible project that is under construction. CONCLUSIONS: The use of portfolios has enabled the education of citizen-health professionals, with academic, pedagogical, and practical emphasis. This indicates that universities and teachers can turn to the development of decision-making capacities and reflective thinking by students.