Interrelationships between dissatisfaction with teaching work and depressive symptoms: Structural equation modelling. / Inter-relações entre insatisfação com o trabalho docente e sintomas depressivos: modelagem com equações estruturais.

The objective of this article is to evaluate the interrelationships of factors associated with depressive symptoms (DS) in teachers, considering dissatisfaction with the teaching job as a possible mediator. This was a cross-sectional study using data from 700 teachers from the public school system of a Brazilian municipality. The outcome of interest was DS, as assessed using the Beck Depression Inventory (BDI). Direct and indirect interrelationships between the outcome and dissatisfaction with work, age, income, lifestyle and adiposity were tested. These variables composed the operational model tested by structural equation modelling. Older age (ß=0.12) and greater dissatisfaction with work (ß=0.12) were directly associated with DS. A more favourable lifestyle (ß=-0.60) and adiposity (ß=-0.10) were associated with a lower occurrence of DS. The variables lifestyle (ß=-0.06) and adiposity (ß=-0.02) also had negative indirect effects on DS, mediated by job dissatisfaction. The structural equation model tested identified interrelationships that influenced DS. Dissatisfaction with teaching work was associated with DS and mediated the relationship of other factors with such symptoms.

O objetivo deste artigo é avaliar inter-relações de fatores associados a sintomas depressivos (SD) em professores, considerando a insatisfação com o trabalho docente como possível mediador. Estudo transversal utilizando dados de 700 professores da rede pública de ensino de um município brasileiro. O desfecho de interesse foi SD aferido pelo Inventário de Depressão de Beck (BDI). Foram testadas inter-relações diretas e indiretas entre o desfecho e insatisfação com o trabalho, idade, renda, estilo de vida e adiposidade. Essas variáveis compuseram modelo operacional testado por meio de modelagem de equações estruturais. A maior idade (ß=0,12) e a maior insatisfação com o trabalho (ß=0,12) associaram-se diretamente aos SD. Já o estilo de vida mais favorável (ß=-0,60) e a adiposidade (ß=-0,10), associaram-se a menor ocorrência de SD. As variáveis estilo de vida (ß=-0,06) e adiposidade (ß=-0,02) também apresentaram efeitos indiretos negativos nos SD, mediados pela insatisfação com o trabalho. O modelo de equação estrutural testado identificou inter-relações que influenciaram os SD. A insatisfação com o trabalho docente associou-se aos SD e mediou a relação de outros fatores sobre tais sintomas.

Inter-relações entre insatisfação com o trabalho docente e sintomas depressivos: modelagem com equações estruturais / Interrelationships between dissatisfaction with teaching work and depressive symptoms: Structural equation modelling

Resumo O objetivo deste artigo é avaliar inter-relações de fatores associados a sintomas depressivos (SD) em professores, considerando a insatisfação com o trabalho docente como possível mediador. Estudo transversal utilizando dados de 700 professores da rede pública de ensino de um município brasileiro. O desfecho de interesse foi SD aferido pelo Inventário de Depressão de Beck (BDI). Foram testadas inter-relações diretas e indiretas entre o desfecho e insatisfação com o trabalho, idade, renda, estilo de vida e adiposidade. Essas variáveis compuseram modelo operacional testado por meio de modelagem de equações estruturais. A maior idade (β=0,12) e a maior insatisfação com o trabalho (β=0,12) associaram-se diretamente aos SD. Já o estilo de vida mais favorável (β=-0,60) e a adiposidade (β=-0,10), associaram-se a menor ocorrência de SD. As variáveis estilo de vida (β=-0,06) e adiposidade (β=-0,02) também apresentaram efeitos indiretos negativos nos SD, mediados pela insatisfação com o trabalho. O modelo de equação estrutural testado identificou inter-relações que influenciaram os SD. A insatisfação com o trabalho docente associou-se aos SD e mediou a relação de outros fatores sobre tais sintomas.

Abstract The objective of this article is to evaluate the interrelationships of factors associated with depressive symptoms (DS) in teachers, considering dissatisfaction with the teaching job as a possible mediator. This was a cross-sectional study using data from 700 teachers from the public school system of a Brazilian municipality. The outcome of interest was DS, as assessed using the Beck Depression Inventory (BDI). Direct and indirect interrelationships between the outcome and dissatisfaction with work, age, income, lifestyle and adiposity were tested. These variables composed the operational model tested by structural equation modelling. Older age (β=0.12) and greater dissatisfaction with work (β=0.12) were directly associated with DS. A more favourable lifestyle (β=-0.60) and adiposity (β=-0.10) were associated with a lower occurrence of DS. The variables lifestyle (β=-0.06) and adiposity (β=-0.02) also had negative indirect effects on DS, mediated by job dissatisfaction. The structural equation model tested identified interrelationships that influenced DS. Dissatisfaction with teaching work was associated with DS and mediated the relationship of other factors with such symptoms.

[Arterial Hypertension and work among teachers of basic education in the public-school system]. / Hipertensão Arterial e trabalho entre docentes da educação básica da rede pública de ensino.

The scope of this paper was to investigate the relationship between Arterial Hypertension (AH) and the occupational profile of teachers of basic public education and present a theoretical model. A probabilistic sample was adopted by clusters, with AH as the dependent variable. The independent variables were grouped in thematic blocks (Sociodemographic Characteristics, Occupational Profile, Behaviors and Health Outcomes) that composed the theoretical model. The analyses were corrected by the sample design. Hierarchical logistic regression was conducted. The prevalence of AH was 25%, and 58% reported dissatisfaction with the work. There was a higher probability of AH among older teachers (OR = 3.7), without postgraduate qualification (OR = 1.4), who also worked in the private network (OR = 2.6), who had a higher salt intake (OR = 1.7), with a high waist-hip ratio (OR = 1.9) and hypercholesterolemia / hypertriglyceridemia (OR = 1, 5) and a lower chance among females (OR = 0.5), who had other work activity (OR = 0.6) and were dissatisfied with the work (OR = 0.6). Thus, the occupational profile of teachers had an influence on AH. The relationship between work and teacher health demands attention and care, with measures that preserve and promote the health and well-being of teachers.

Objetivou-se investigar a relação entre Hipertensão Arterial (HA) e perfil ocupacional de docentes da educação básica pública e apresentar modelo teórico. Adotou-se amostra probabilística por conglomerados. A HA foi a variável dependente. As variáveis independentes foram agrupadas em blocos temáticos (Características Sociodemográficas, Perfil Ocupacional, Comportamentos e Desfechos em Saúde), que compuseram o modelo teórico. As análises foram corrigidas pelo desenho amostral. Foi conduzida regressão logística hierarquizada. A prevalência de HA foi de 25%, enquanto que 58% apresentaram insatisfação com o trabalho. Houve maior chance de HA entre os docentes mais velhos (OR = 3,7), sem pós-graduação (OR = 1,4), que atuavam também na rede privada (OR = 2,6), que apresentavam maior consumo de sal (OR = 1,7), com sobrepeso (OR = 2,1) / obesidade (OR = 7,2), com relação cintura-quadril elevada (OR = 1,9) e com hipercolesterolemia/hipertrigliceridemia (OR = 1,5) e menor chance entre os do sexo feminino (OR = 0,5), que exerciam outra atividade de trabalho (OR = 0,6) e insatisfeitos com o trabalho (OR = 0,6). Assim, o perfil ocupacional docente apresentou influência sobre a HA. A relação trabalho e saúde docente carece de atenção e cuidado, com adoção de medidas que preservem e promovam sua saúde e seu bem-estar.

Hipertensão Arterial e trabalho entre docentes da educação básica da rede pública de ensino / Arterial Hypertension and work among teachers of basic education in the public-school system

Resumo Objetivou-se investigar a relação entre Hipertensão Arterial (HA) e perfil ocupacional de docentes da educação básica pública e apresentar modelo teórico. Adotou-se amostra probabilística por conglomerados. A HA foi a variável dependente. As variáveis independentes foram agrupadas em blocos temáticos (Características Sociodemográficas, Perfil Ocupacional, Comportamentos e Desfechos em Saúde), que compuseram o modelo teórico. As análises foram corrigidas pelo desenho amostral. Foi conduzida regressão logística hierarquizada. A prevalência de HA foi de 25%, enquanto que 58% apresentaram insatisfação com o trabalho. Houve maior chance de HA entre os docentes mais velhos (OR = 3,7), sem pós-graduação (OR = 1,4), que atuavam também na rede privada (OR = 2,6), que apresentavam maior consumo de sal (OR = 1,7), com sobrepeso (OR = 2,1) / obesidade (OR = 7,2), com relação cintura-quadril elevada (OR = 1,9) e com hipercolesterolemia/hipertrigliceridemia (OR = 1,5) e menor chance entre os do sexo feminino (OR = 0,5), que exerciam outra atividade de trabalho (OR = 0,6) e insatisfeitos com o trabalho (OR = 0,6). Assim, o perfil ocupacional docente apresentou influência sobre a HA. A relação trabalho e saúde docente carece de atenção e cuidado, com adoção de medidas que preservem e promovam sua saúde e seu bem-estar.

Abstract The scope of this paper was to investigate the relationship between Arterial Hypertension (AH) and the occupational profile of teachers of basic public education and present a theoretical model. A probabilistic sample was adopted by clusters, with AH as the dependent variable. The independent variables were grouped in thematic blocks (Sociodemographic Characteristics, Occupational Profile, Behaviors and Health Outcomes) that composed the theoretical model. The analyses were corrected by the sample design. Hierarchical logistic regression was conducted. The prevalence of AH was 25%, and 58% reported dissatisfaction with the work. There was a higher probability of AH among older teachers (OR = 3.7), without postgraduate qualification (OR = 1.4), who also worked in the private network (OR = 2.6), who had a higher salt intake (OR = 1.7), with a high waist-hip ratio (OR = 1.9) and hypercholesterolemia / hypertriglyceridemia (OR = 1, 5) and a lower chance among females (OR = 0.5), who had other work activity (OR = 0.6) and were dissatisfied with the work (OR = 0.6). Thus, the occupational profile of teachers had an influence on AH. The relationship between work and teacher health demands attention and care, with measures that preserve and promote the health and well-being of teachers.

Efeitos do ultrassom terapêutico no ingurgitamento mamário: estudo piloto / Effects of therapeutic ultrasound in mammary engagement: pilot study

INTRODUÇÃO: A amamentação constitui uma importante etapa no processo reprodutivo, oferecendo benefícios tanto para mãe como para a criança. O Ingurgitamento mamário é uma complicação que ocorre do terceiro ao quinto dia de pós-parto. O Ultrassom Terapêutico (UST) é amplamente utilizado, e consiste em um aparelho capaz de produzir energia acústica de alta frequência. OBJETIVO: verificar o efeito agudo do ultrassom no processo terapêutico do ingurgitamento mamário. METODOLOGIA: Estudo transversal, que avaliou a mama e classificou o ingurgitamento, além de realizar avaliação da dor e da percepção subjetiva das mamas. Foi administrado o protocolo com ultrassom terapêutico na frequência de 1Mh, modo pulsado, intensidade/ dose de 0,5w/cm2, ciclo ativo de 20% com tempo de aplicação de 02 minutos por área de radiação efetiva (ERA). Após aplicação, a lactente foi submetida à amamentação e realizada nova avaliação das mamas. RESULTADOS: A amostra foi composta por 4 mulheres entre 20 e 30 anos com quadro de ingurgitamento mamário. O valor inicial do ingurgitamento mamário foi de 2 a mediana e a final foi de 1 a mediana. Em relação à dor mamária, inicialmente foi de 5 mediana e a final 2 a mediana. Em todos os casos analisados houve melhora na dor, na disponibilidade do leite e no aspecto de ingurgitamento da mama. CONCLUSÃO: O ultrassom terapêutico se mostrou eficaz na redução da dor, no aumento da disponibilidade do leite e na melhora do enrijecimento característico do ingurgitamento mamário.

INTRODUCTION: Breastfeeding is an important step in the reproductive process, providing benefits for both mother and child. Breast engorgement is a complication that occurs from the third to the fifth postpartum day. Therapeutic Ultrasound (UST) is widely used, and consists of an apparatus capable of producing high frequency acoustic energy. OBJECTIVE: to verify the acute effect of ultrasound in the therapeutic process of breast engorgement. METHODOLOGY: Cross-sectional study, which evaluated the breast and classified the engorgement, besides evaluating the pain and the subjective perception of the breasts. The protocol with therapeutic ultrasound was administered at a frequency of 1Mh, pulsed mode, intensity / dose of 0.5w / cm2, active cycle of 20% with application time of 02 minutes per effective Radiation Area (ERA). After application, the infant was submitted to breastfeeding and a new breast evaluation was performed. RESULTS: The sample consisted of 4 women between 20 and 30 years of age with breast engorgement. The initial value of breast engorgement was 2 the median and the final value was 1 to median. Regarding breast pain, it was initially 5 median and the final 2 median. In all the analyzed cases there was improvement in pain, milk availability and breast engorgement aspect. CONCLUSION: Therapeutic ultrasound has been shown to be effective in reducing pain, increasing milk availability and improving the stiffness characteristic of breast engorgement.

Características de recém-nascidos de muito baixo peso admitidos em Unidade de Terapia Intensiva Neonatal / Characteristics of newborn of very low weight admitted to Intensive Neonatal Care Unit / Características de recién nacidos de muy bajo peso admitidos en la Unidad de Cuidados Intensivos Neonatal

Objetivo: descrever as características de recém-nascidos de muito baixo peso em uma Unidade de Terapia Intensiva Neonatal. Método: estudo transversal, com análise dos prontuários de recém-nascidos realizado entre janeiro/2007 e junho/2012. Foram identificadas variáveis demográficas, gestacionais, referentes ao parto e ao recém-nascido, que foram submetidas a análises descritivas. O projeto de pesquisa teve a aprovação pelo Comitê de Ética em Pesquisa, sob o Protocolo 626/07. Resultados: foram analisadas 184 crianças, sendo 53,8% do sexo feminino. O peso de nascimento variou de 450 a 1400 gramas, 23,9% evoluíram para o óbito. 53,8% das mães possuíam até 31 semanas gestacionais, 59,2% realizaram entre 4 e 6 consultas de pré-natal, 82,6% apresentavam risco e 47,3% foram internadas durante a gestação. 61,4% tiveram partos por cesariana. Conclusão: a identificação de aspectos passíveis de intervenção pode proporcionar mudanças nas condutas assistenciais dispensada à gestante e ao recém-nascido.(AU)

Objective: describing the characteristics of newborns with very low weight in a Neonatal Intensive Care Unit. Method: a cross-sectional study with analysis of newborn medical records carried out between January 2007 and June 2012. There were identified demographic variables, pregnancies, regarding labor and the newborn, which were submitted to descriptive analysis. The research project was approved by the Research Ethics Committee, under the Protocol 626/07. Results: there were analyzed 184 children, being 53,8% female. Birth weight ranged from 450 to 1400 grams, 23,9% had a fatal outcome. 53,8% of mothers had up to 31 weeks gestation, 59,2% had between 4 and 6 pre-natal consultations, 82,6% were at risk and 47,3% were hospitalized during pregnancy. 61,4% gave birth by Caesarean section. Conclusion: the identification of aspects which intervention can provide changes in care behaviors given to pregnant women and newborns.(AU)

Objetivo: describir las características de los recién nacidos con muy bajo peso en una Unidad de Cuidados Intensivos Neonatales. Método: un estudio transversal con el análisis de las historias clínicas de recién nacidos llevados a cabo entre enero 2007 y junio 2012. Las variables demográficas fueron identificados los embarazos, con respecto a la mano de obra y el recién nacido, las cuales fueron sometidos a un análisis descriptivo. El proyecto de investigación fue aprobado por el Comité de Ética en la Investigación, en el marco del Protocolo 626/07. Resultados: se analizaron 184 niños, y el 53,8% eran mujeres. El peso al nacer osciló 450-1400 gramos, 23,9% tenían un desenlace fatal. 53,8% de las madres tenía hasta 31 semanas de gestación, el 59,2% tenían entre 4 y 6 consultas prenatales, el 82,6% estaban en riesgo y el 47,3% fueron hospitalizados durante el embarazo. 61,4% dio a luz por cesárea. Conclusión: la identificación de los aspectos que la intervención puede aportar cambios en los comportamientos de cuidado dado a las mujeres embarazadas y los recién nacidos.(AU)

Understanding of technical education level professionals regarding sickle cell disease: a descriptive study

Aim: To assess the understanding of technical education level professionals who work in Primary Health Care units regarding sickle cell disease in children. Method: This is a descriptive and transversal study, involving 357 health community agents and nursing technicians who responded to a structured questionnaire. The performance was tested in terms of the average score for every stage of the questionnaire. Results: The average score was below 65% in all stages, with critical results in the stages “clinical manifestations” and “management of children with sickle cell disease”. There was a statistical association between the best performance and the following variables: role in the team (OR=5.92; IC95%=1.90-20.49) and the level of interaction with the sickness (OR=1.71; IC95%=1.09-2.69). Discussion: The professionals must be able to assist children with sickle cell disease. Conclusion: The lack of information on the part of the professionals that care for and handle children with sickle cell disease, indicates the need to develop these professionals in such a way as to improve the quality of the service provided.

Fatores de risco para a mortalidade de recém-nascidos de muito baixo peso em unidade de terapia intensiva neonatal / Risk factors for the mortality of very low birth weight newborns at a neonatal intensive care unit / Factores de riesgo para la mortalidad de recién nacidos de muy bajo peso en unidad de terapia intensiva neonatal

OBJETIVO: Identificar os fatores associados à mortalidade de recém-nascidos de muito baixo peso internados em uma Unidade de Terapia Intensiva Neonatal de referência no Norte de Minas Gerais, Brasil. MÉTODOS: Estudo transversal baseado na análise de prontuários de uma amostra aleatória de recém-nascidos admitidos em uma Unidade de Terapia Intensiva Neonatal de janeiro de 2007 a junho de 2010. Foram considerados elegíveis para o estudo recém-nascidos com peso inferior a 1500g, provenientes do bloco obstétrico da própria instituição. Foram identificadas variáveis demográficas maternas, variáveis relacionadas às condições de gestação e parto e variáveis do recém-nascido. A associação entre as variáveis foi aferida por meio do teste do qui-quadrado e Odds Ratio. As variáveis associadas até o nível de 25% (p<0,25) na análise bivariada foram inseridas na análise múltipla por meio da regressão logística, assumindo-se o nível de significância de 5% (p<0,05). RESULTADOS: Foram selecionados e analisados os dados referentes a 184 prontuários, que registraram 44 óbitos (23,9%). As variáveis que se mantiveram estatisticamente associadas ao óbito de recém-nascidos de muito baixo peso, após análise multivariada, foram: peso de nascimento abaixo de 1000g (OR 7,29; IC95% 3,19 - 16,63; p<0,001), boletim de Apgar de 1º minuto menor do que sete (OR 3,57; IC95% 1,53 - 8,32; p=0,003) e realização de menos de quatro consultas de pré-natal (OR 2,72; IC95% 1,19 - 6,23; p=0,018). CONCLUSÕES: Os resultados denotam falhas na assistência pré-natal e a necessidade de melhoria em relação aos cuidados perinatais ao binômio mãe e filho.

OBJECTIVE: To identify variables associated with mortality among very low birth weight infants admitted to a Neonatal Intensive Care Unit in Minas Gerais, Southeastern Brazil. METHODS: Cross-sectional study based on chart data of a random sample of premature newborn infants admitted to a Neonatal Intensive Care Unit from January 2007 to June 2010. Inborn infants weighing less than 1500g were eligible for the study. Maternal demographic variables, variables related to health conditions during pregnancy and delivery and variables related to newborn infants were collected. The association between variables was measured by chi-square test and Odds Ratio. Variables associated up to the level of 25% (p<0.25) in the bivariate analysis were included in the multivariate analysis by logistic regression, assuming a significance level of 5% (p<0.05). RESULTS: Data of 184 patients were analyzed, and 44 (23.9%) of them died. The variables that remained statistically associated with death in very low birth weight infants after the multivariate analysis were: birth weight below 1000g (OR 7.29; 95%CI 3.19 - 16.63; p<0.001), Apgar Score at the 1st minute <7 (OR 3.57; 95%CI 1.53 - 8.32, p=0.003), and report of less than four prenatal visits (OR 2.72; 95%CI 1.19 - 6.23, p=0.018). CONCLUSIONS: The results show gaps in prenatal care and the need for perinatal care improvement addressed to both mothers and infants.

OBJETIVO: Identificar los factores asociados a la mortalidad de recién nacidos de muy bajo peso, internados en una Unidad de Terapia Intensiva Neonatal de referencia en el Norte de Minas Gerais, Brasil. MÉTODOS: Estudio transversal, basado en el análisis de prontuarios de una muestra aleatoria de recién nacidos admitidos en una Unidad de Terapia Intensiva Neonatal desde enero de 2007 hasta junio de 2010. Fueron considerados elegibles para el estudio los recién nacidos con peso inferior a 1.500g, provenientes del bloque obstétrico de la propia institución. Fueron identificadas variables demográficas maternas, variables relacionadas a las condiciones de gestación y parto y variables del recién nacido. La asociación entre las variables fue verificada por medio de la prueba de chi cuadrado y Odds Ratio. Las variables asociadas hasta el nivel de 25% (p<0,25), en el análisis bivariado, fueron insertadas en el análisis múltiple por medio de la regresión logística, asumiéndose el nivel de significancia de 5% (p<0,05). RESULTADOS: Fueron seleccionados y analizados los datos referentes a 184 prontuarios, que registraron 44 óbitos (23,9%). Las variables que se mantuvieron estadísticamente asociadas al óbito de recién nacidos de muy bajo peso, después de análisis multivariado, fueron: peso de nacimiento inferior a 1.000g (OR 7,29; IC95% 3,19-16,63; p<0,001), boletín de Apgar de primer minuto inferior a siete (OR 3,57; IC95% 1,53-8,32; p=0,003) y realización de menos de cuatro consultas de prenatal (OR 2,72; IC95% 1,19-6,23; p=0,018). CONCLUSIONES: Los resultados denotan fallas en la asistencia prenatal y la necesidad de mejorías respecto a los cuidados perinatales al binomio madre e hijo.

Quality of assistance provided to children with sickle cell disease by primary healthcare services.

OBJECTIVE: To evaluate the quality of healthcare provided to sickle cell disease children by primary healthcare services in a region of high prevalence. METHODS: A cross-sectional, descriptive study was performed by interviewing members of families with sickle cell disease children. The children had been identified from the Neonatal Screening Program in Minas Gerais state over the last 12 years in towns of the Montes Claros-Bocaiuva microregion. A structured questionnaire specially developed for this study and based on three axes was used: indicators of the child's health (immunization, growth and development, prophylaxis antibiotic therapy), perception of care by the family (health education and accessibility) and knowledge of the family about the disease. RESULTS: Sixty-three of 71 families with children identified as having sickle cell disease were interviewed. The predominant genotypes were Hb SS (44.4%) and Hb SC (41.2%). Adequate monitoring of growth and development was recorded for the first year of life in 23 children (36.6%) and for the second year of life in 18 children (28.6%). The basic vaccination schedule was completed by 44 children (69.8%) but 62 vaccination record cards (98.4%) identified delays of special vaccines. Regular use of prophylactic penicillin was reported by 55 caregivers (87.3%). The family's perception of the care provided suggests poor accessibility to health services and lack of opportunities to answer doubts. The average performance of families in knowledge testing was 59.8%. CONCLUSION: The quality of healthcare is unsatisfactory. The care provided to children with sickle cell disease in primary healthcare services needs improvements.

Quality of assistance provided to children with sickle cell disease by primary healthcare services

OBJECTIVE: To evaluate the quality of healthcare provided to sickle cell disease children by primary healthcare services in a region of high prevalence. METHODS: A cross-sectional, descriptive study was performed by interviewing members of families with sickle cell disease children. The children had been identified from the Neonatal Screening Program in Minas Gerais state over the last 12 years in towns of the Montes Claros-Bocaiuva microregion. A structured questionnaire specially developed for this study and based on three axes was used: indicators of the child's health (immunization, growth and development, prophylaxis antibiotic therapy), perception of care by the family (health education and accessibility) and knowledge of the family about the disease. RESULTS: Sixty-three of 71 families with children identified as having sickle cell disease were interviewed. The predominant genotypes were Hb SS (44.4 percent) and Hb SC (41.2 percent). Adequate monitoring of growth and development was recorded for the first year of life in 23 children (36.6 percent) and for the second year of life in 18 children (28.6 percent). The basic vaccination schedule was completed by 44 children (69.8 percent) but 62 vaccination record cards (98.4 percent) identified delays of special vaccines. Regular use of prophylactic penicillin was reported by 55 caregivers (87.3 percent). The family's perception of the care provided suggests poor accessibility to health services and lack of opportunities to answer doubts. The average performance of families in knowledge testing was 59.8 percent. CONCLUSION: The quality of healthcare is unsatisfactory. The care provided to children with sickle cell disease in primary healthcare services needs improvements.