Avaliação das ações voltadas à saúde da mulher na Atenção Básica, Brasil, 2014.

Abstract

Objective: Evaluate actions to women's health operationalized in Primary Health Care (PHC) in Brazil in 2014. Method: Evaluative research of Primary Care, with data gathered in 2014, in external evaluation phase from National Program for the Improvement of Access and Quality of Primary Care - PMAQ, second series. Data from all brazilian territory were used, totaling 29.778 work groups that had a professional nurse as responding. We have selected variables related to this research and calculate the percentage of positive replies individually and grouped by municipality. The variables were organized and studied according to the issues 'Planning, organization and support to the work process', 'Flow monitoring', 'Management of assistance' and 'Development of actions'. In the study, were assign 1 point if percent higher or equal to 80%. This way, we have reached the rating of the issues and the final rating, "Low", "Medium" and "High". Finally, we have tested the link of the rating of the pattern of the issues with the big brazilian's regions, "Municipal Human Development Index" and with the Indicators of assistance to women’s health: Proportion of born alive with 7 or more prenatal visits, Ratio of held mammography and Ratio of held cytopathological exam. Results: In relation to planning, the regions South and Central-west are significant to rating "Low"; In 'Flow monitoring' and 'Assistance management ' only Southeast are related as rating "High"; In 'Development actions', North and Northeast have rating "Low". The municipalities with higher thirds of the "Municipal Human Development Index" (IDHM) are related with the rating "Low", except in planning. The higher share of the municipal's indicators of assistance to women are related to rating "High". We have also emphasized, that between the issues, in Brazil the main weakness in region North are: use of protocols for early training of the pregnant women; planning of the actions; return of the evaluation hald by the users of the transferred users; record of the territory of the eligible women for mammography exam and appointment booking in any day and time and; actions to ensure the puerperium consultation until 10 days after the childbirth. In Central-west: monitoring of the pregnant women that had delivered; hold quick pregnancy test, syphilis and HIV, in addition to educational actions targeted to women's health. Conclusion: Actions aimed at the women's primary health care in Brazil are short of the proposed guidelines, reflected by the ranking downgrades of the actions issues and the regionals differences detected. The nurse can intervene in all identified fragilities in actions aimed at the women's health in "APD", except those related to services organization of "Health Care Networks".