Full text
| |
| Author(s): |
Luciane Ferreira do Val
Total Authors: 1
|
| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Escola de Enfermagem (EE/SBD) |
| Defense date: | 2012-11-29 |
| Examining board members: |
Lucia Yasuko Izumi Nichiata;
Lourdes Bernadete dos Santos Pito Alexandre;
Jose Leopoldo Ferreira Antunes;
Marcia de Lima;
Regina Maria Giffoni Marsiglia
|
| Advisor: | Lucia Yasuko Izumi Nichiata |
| Abstract | |
Implementation of comprehensive attention is a huge challenge in the consolidation of the Brazilian Unified Health System. The vulnerability to STD/HIV/Aids in Primary Care was focused on this study, aiming to provide tools to improve healthcare. The objectives of the study were: 1) to characterize Primary Care Units (PCU) according to selected variables such as: administrative hierarchy position (Regional Health Coordination, Healthcare Technical Supervision), administrative issues (models healthcare attention of organization, Healthcare Social Organization (HSO) in management or co-management with the Township Healthcare Office in São Paulo), and manager formal professional qualification; 2) to identify the level of Programmatic Vulnerability; and 3) to assess the Programmatic Vulnerability according to the following components: accessibility, point of entry, links, family approach, health professional and integration / coordination. The conceptual approach was the vulnerability in its programmatic dimension. This was a transversal descriptive and quantitative study based on an online survey with 51 questions applied in the FormSUS platform and involving managers from 442 PCU of the city of São Paulo. Responses were received from 328 PCU managers; among them more than half were Nurses. PCU were exclusively \"conventional in 40.9% and 55.8% of the HSO were classified as \"association\". There were different levels of programmatic vulnerability; in general however, the vulnerability was low. There was vulnerability in making comprehensive attention effective: lacking of material for educational activities; insufficiency of availability of tests to detect syphilis in pregnant women and anti-HIV test in the pre-natal period; excessive delay in results of anti-HIV tests causing them to be not time-opportune; low practice of indication of syphilis treatment with Benzathine Penicillin for the pregnant partner; lacking of informed consent to request HIV testing to pregnant women as well general population; lacking of training for the syndromic approach to STDs; lacking of counseling when offering HIV testing; lacking of counter-reference to PCU, STD/Aids. It was concluded that the translation of the comprehensiveness concept into health practices regarding STD/HIV/aids enabled us to assess programmatic vulnerabilities in the PCU, and pointed out challenges to achieve a true comprehensive healthcare attention. (AU) | |
| FAPESP's process: | 09/14346-0 - CHALLENGES IN COMPREHENSIVENESS OF ATTENTION TO STD/HIV/AIDS: VULNERABILITY OF THE PROGRAMS IN BASIC HEALTH UNITS IN THE CITY OF SÃO PAULO |
| Grantee: | Luciane Ferreira do Val |
| Support Opportunities: | Scholarships in Brazil - Doctorate |