Access to public health services and integral care for women during the puerperal gravid period period in Ceará, Brazil.

BACKGROUND: Over time, the Brazilian health system, a growing country, has been developing to ensure good accessibility to health goods and services. This development is focusing on the principle of universality of access and completeness of health care. In this context, we aimed to evaluate the completeness of care and universality of access for women in their pregnancy and puerperal period in Ceará, Brazil. METHODS: A descriptive, cross-sectional study based on a quantitative approach, using information collected from the database of the regulation system of the state of Ceará and data from the Prenatal Monitoring System. The research population comprised of 1701 women who delivered a baby in an obstetric reference unit in the Health Macro-Region of Cariri, Ceará, Brazil from January to December 2015. RESULTS: There was a high rate of cesarean delivery (49.7%) and a high waiting time for access to high-risk delivery (32.6%) and neonatal intensive care unit (72.9%). There was also a low percentage (41.1%) of pregnant women undergoing an adequate number of prenatal consultations, dental care (20%), educational activities (15%), visits to the maternity ward (0.1%), laboratory tests of the third trimester (29.2%) and puerperal consultation (37.9%). CONCLUSIONS: It was concluded that the Maternal and Child Health Policy, especially the Rede Cegonha, which is still under development, does not ensure access and completeness of care for women during the prenatal, delivery, and puerperal periods, thus violating their reproductive rights. The results of this study allow a critical analysis by the academia and health managers in search of strategies to improve the services of Rede Cegonha in Brazil.

Impacto do Programa Mais Médicos na atenção básica de um município do sertão central nordestino / The impact of the Program More Doctors in the basic atention in a north east location county

Tendo em vista os problemas inerentes à atenção primária a saúde, o Governo Federal implantou o Programa Mais Médicos para o Brasil em busca de melhoria na assistência e do acesso à atenção primária a saúde com vistas de proporcionar qualidade de vida aos usuários do Sistema Único de Saúde -SUS através da prevenção e promoção da saúde. Este estudo visou identificar os impactos causados pela implementação do Programa Mais Médicos em um município do sertão central nordestino. O estudo foi constituído a partir da análise estatística dos indicadores registrados no Sistema de informação da Atenção Básica SIAB. Os dados foram processados no software Stata®, na versão 11.0, onde, a partir da análise estatística descritiva, os resultados foram analisados e apresentados em tabelas. O estudo identificou que a partir da implementação do Programa Mais Médicos houve um aumento considerável no número de consultas e atendimentos realizados pelos médicos, tendo destaque os atendimentos prestados aos pacientes portadores de tuberculose e hanseníase e impacto nas solicitações dos exames complementares que sofreu uma queda bastante considerável. Outro ponto identificado é o aumento de visitas domiciliares. Pode se realizar uma análise de forma geral de melhoria dos indicadores da saúde no município depois do Programa Mais Médicos implantado segundo resultados estatísticos apresentados.

Because of problems in Brazil’s primary health care attention, the Federal Government created the Mais Médicos Program. This Program comprises a series of actions intended to better assistance in the segment of primary health care attention and have the great responsibility to promote the life quality of the Brazilian national health system (SUS) users, and became possible through the health promotion and prevention. This study aims at identifying impacts that come out with the Mais Médicos Program implementation in a north east location county, through the analysis of statistical indicators registered in the basicattention information system (SIAB). The data were processed by software Stata 11.0 and are shown as descriptive statistics and tables. The work identified an important increase in numbers of medical appointments, given a special emphasis in medical appointments to tuberculosis and hanseniase suffers, as well as a decrease number in extras exams solicitations. Another point identified that deserves merit is the demand of home visit by the doctor. In this way can be perform, in a general form, an improvement of health indicators in the county after the Mais Médicos Program based on real statistics results.