Avaliação dos atributos essenciais da Atenção Básica em Saúde da Criança: estudo de caso no Distrito de Saúde Norte da cidade de Manaus/AM

Abstract

The Primary Health Care (APS) has been strengthened after the International Conference of Alma-Ata. Brazil has chosen the Family Health Strategy (FHS) to operationalize the PHC, as ordering the care model based on the principles of the Unified Health System (UHS). The APS has attributes which, being applied, favoring the quality of care, especially for children. This study aimed to evaluate the essential attributes of APS in health care for children offered by the FHS teams in the north of Manaus and identify the factors associated with essential score through the PCATool. This is an evaluative study and we used two instruments for data collection: a questionnaire on socioeconomic characteristics and the Primary Care Assessment Tool (PCATool) Brazil Child version. The study included 320 mothers of children under two years living and registered in the areas of coverage of the FHS teams. The analysis followed the recommendations of PCATool-Brazil Guide. As for the essential attributes of APS, showed satisfactory scores (≤ 6.6) only attributes Access - Use (6.7) and Coordination - Information System (8.7); the other attributes presented low scores: Access - Accessibility (5.0), Longitudinality (6.5), Coordination - Integration of Care (6.5), Comprehensiveness - Services Available (5.5) and Services (6.1). The Essential attribute score of APS was unsatisfactory (6.5) and shows that APS must move towards providing effective access and comprehensive care for children. The component degree of affiliation showed an average 6.7. Statistically significant between Essential score of APS and socioeconomic associations were identified, meaning that the outcome of Essential score can be attributed only to the health service offered. The α Cronbach presented value >0.75, reinforcing the validity of the instrument. The study revealed that the health care of children under two years in the FHS is not guided by APS and presents less effective, with problems related to access, difficulties in creating bond with the child/family, persistent fragmentation of care and coordination of care deficient. There is need for reorientation of health actions, in order to modify and improve the quality of care provided to the child population, which because of their vulnerability, makes up one of the priority areas in the country.