O impacto da expansão da estratégia saúde da família em indicadores na área de planejamento 5.3 no município do Rio de Janeiro.

• Autor(a) principal: Ferreira, Luciana de Almeida
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4337
• topic: Family health strategy; Coverage; Health indicators; Estratégia de saúde da família; Cobertura; Indicadores de saúde; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA

The family health strategy was the choice model used for the reorganization of the Brazilian basic care. Its implementation in the municipality of Rio de Janeiro began in 1995 taking small steps. As from 2009, a FHS implementation and expansion process takes place and the 5.3 planning area is chosen as a priority area for that expansion. It is believed that the FHS expansion, the increased coverage of the population assisted and the increase in the access to healthcare services will result in improvement of the population health and, therefore, it will impact the health indicators positively. This paper aims at analyzing the impacts of the FHS expansion in health indicators selected in the AP 5.3 in the municipality of Rio de Janeiro, from 2009 to 2012. The specific objectives are (1) to describe the expansion of the FHS coverage between 2009 and 2012 in the AP 5.3; (2) to analyze the evolution of the health indicators during that same period; (3) to correlate the health indicators with the increased family healthcare coverage; and (4) to compare the data found in the AP 5.3 with those from the municipality of Rio de Janeiro. This is a time-series ecological study. The health indicators selected for analysis in this study were chosen taking into account FHS structure and performance elements, as well as the state of health of the population, in situations in which relationships between FHS actions and modifications in the healthcare profile could be established. The results found in relation to the expansion of the FHS coverage in the AP 5.3 showed a raise from 41% in August 2010 to 98% in June 2012, and reached 100% in September 2013. In this region, the outpatient throughput increased in 130%. The percentage of live births that carried out 7 or more prenatal care appointments, between 2009 and 2012, increased in 3%. The percentage of live births thorough Cesarean delivery in the AP 5.3 has increased along the period analyzed. In that region, however, more than 50% of the deliveries carried out are still vaginal. In the AP 5.3, the child mortality rate dropped 6.84%, from 2009 to 2012. In turn, the neonatal mortality rate increased in 16% in the same period. Meanwhile, the post-neonatal mortality rate was reduced in 33% in that region from 2009 to 2012. The results found in this study suggest a positive contribution of the program to the evolution of many healthcare indicators of the population. Nevertheless, some actions and services need improvement in order to ensure a higher quality full assistance to its users. More than expanding access by increasing the coverage, it is necessary to ensure the quality of the assistance.