RESUMEN
BACKGROUND: The provision of care and monitoring of health are essential for indigenous Venezuelans from the Warao ethnic group, who are at risk of decimation. OBJECTIVE: Analyze a Local Action Plan (LAP) to promote access to the health system of indigenous Venezuelans from the Warao ethnic group (IVWEG) in Manaus, Brazil. METHOD: A mixed-methods study was performed. Quantitative data were collected to assess the provision of care and monitoring of health conditions in IVWEG through a survey that was self-completed by healthcare providers. Qualitative narrative data were collected to gain insight into IVWEG that seek care. We applied descriptive statistics, grouping analysis (GA) by hierarchical levels, and multiple correspondence analysis (MCA). Content analysis was applied to qualitative data. RESULTS: 106 healthcare providers participated in the study, with the following characteristics: 94 (88.7%) females, 67 (63.2%) pardo race/color, 40 (37.7%) working in primary healthcare, and 49 (46.2%) nurses. In addition, 43 (40.6%) of the healthcare providers reported providing care to IVWEG. Among the providers, 89 (84%) had received training for assisting IVWEG. Additionally, 30 IVWEG were enrolled for interviews in the qualitative phase. The barriers to seeking care were language, distance to health units, and lack of money for transportation. The LAP proved to facilitate access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus. The study contributed to knowledge on a LAP addressed to IVWEG and helped improved their access to the health system, providing appropriate training for healthcare providers and other relevant actors by implementing a coherent and consistent public health policy at the local level.
Asunto(s)
Accesibilidad a los Servicios de Salud , Brasil , Etnicidad , Femenino , Servicios de Salud del Indígena , HumanosRESUMEN
O objetivo foi analisar a completude dos campos das investigaçõesda base de dados de gestante Vírus da Imunodeficiência Humana(HIV) positivoe criança exposta do Sistema de Informação de Agravos de NotificaçãoCompulsória (SINAN), no Espírito Santo, entre 2001 a 2006. Estudo descritivo,retrospectivo, com utilização de dados secundários. Para avaliar a completude,foram utilizados os parâmetros: excelente (maior que 90%), regular (entre 70%e 89%) e ruim (abaixo de 70%). Calculou-se a média de completude de 34 variáveis,utilizando-se a base nacional do SINAN. As variáveis analisadas foramsubdivididas em blocos: informação da notificação; informação da mãe; AIDSna gravidez; informação da criança; aleitamento; histórico da criança; dados laboratoriaise acompanhamento. As variáveis raça/cor e escolaridade apresentaramcompletude excelente no Estado. Dentre os fatores que contribuem para aredução da transmissão vertical do HIV, as variáveis evolução da gravidez, inícioda profilaxia no recém-nascido e aleitamento materno foram classificadas comoregular, enquanto o aleitamento cruzado foi considerado ruim. As informaçõesreferentes à criança exposta ao vírus foram as que apresentaram menor grau depreenchimento. Conclui-se que dados relativos à prevenção da TV estão incompletos.A notificação, por ser realizada na maioria das vezes no período gestacional,apresenta falhas nas informações referentes à criança. Há necessidade demaiores esclarecimentos aos profissionais de saúde sobre a importância do preenchimentodos campos, para que seja possível traçar estratégias para prevençãoe controle da TV no Espírito Santo.
The objective was to analyze thecompleteness of the s of investigations ofthe database of HIV positive pregnant womenand children exposed to the Information SystemDiseases Notification Compulsória (SINAN),in the Espirito Santo, from 2001 to 2006. Descriptivestudy, retrospective, the use of secondarydata. To evaluate the completeness were usedthese parameters: excellent (greater than 90%),regular (between 70% and 89%) and poor (below70%) calculated the mean of completion of 34variables, using the base ?s national SINAN.The variables examined were divided into blocks:information of the notification; information of themother; AIDS in pregnancy; information of thechild; lactation; history of the child; laboratorydata and monitoring. Variables race / color andcompleteness showed excellent schooling in the state.Among the factors that contribute to the reductionof vertical transmission of HIV, the variablesevolution of pregnancy, initiation of prophylaxisin newborns and breastfeeding were classified asregular, while breastfeeding cross was consideredbad. Information regarding child exposed to thevirus were those who had lower degree of filling.It is concluded that data on the prevention of TVare incomplete. The notification to be performedmost often in the gestational period shows flaws inthe information concerning the child. There is needfor further clarification to health care professionalson the importance of filling in the s, in orderto draw strategies for prevention and control of theTV in the Holy Spirit.