Quality of infant care in primary health services in Southern and Northeastern Brazil
Quality of infant care in primary health services in Southern and Northeastern Brazil
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DOI：
10.11606/s1518-8787.2018052000186
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发表时间：
2018-01-01
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影响因子：
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通讯作者：
Tomasi, Elaine
中科院分区：
文献类型：
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作者：
Santos, Andréia Soprani dos;Duro, Suele Manjourany Silva;Tomasi, Elaine
目的：评估巴西南部和东北部地区初级卫生服务机构为一岁以下儿童提供的医疗服务质量。方法：这是一项基于人口的横断面研究，于2010年进行，调查对象为7915名1-4岁儿童，他们的家位于卫生服务覆盖地区。我们描述了程序和指南的流行率，如体重和身高测量、疫苗接种、新生儿血斑筛查、脐带评估、母乳喂养指导和新食物的引入，以及它们各自的95%可信区间。差异分析采用异质性和线性趋势卡方检验。我们认为，如果孩子在出生第一年就接受了所有推荐的程序和指南，那么高质量婴儿护理的主要结果。结果：婴儿出生后第1周母乳喂养指导的患病率较低(58.8%，95%可信区间为57.5~60.0)，护理4个月时引入新食物的患病率较低。优质托儿服务的普及率为42.0%(95%可信区间为40.5~43.5)。根据分层模型进行的校正分析显示，东北地区(PR=1.17，95%CI 1.09~1.26)、较小的直辖市(PR=1.17，95%CI 1.03~1.33)、5万和9.9万人口的直辖市(PR=1.20，95%CI 1.09~1.34)发生这种情况的概率较大。结论：东北地区的婴幼儿护理服务质量较高，这可以通过该地区家庭健康战略的整合来解释。
OBJECTIVE: To assess the quality of the health care provided to children aged under one year old performed by primary health services in the South and Northeast regions of Brazil.METHODS: This is a cross-sectional, population-based study carried out in 2010 with 7,915 children aged from one to four years, whose homes are located in the areas of health service coverage. We described the prevalence of procedures and guidelines, such as weight and height measurement, vaccination, newborn blood spot screening, evaluation of umbilical cord, instruction on breastfeeding and introduction of new food, and their respective 95% confidence intervals. The differences were analyzed using the chi-square test of heterogeneity and linear trend. We considered the main outcome of high-quality infant care if the child had received all recommended procedures and guidelines in the first year of life. For this analysis, we used the Poisson regression considering hierarchical model.RESULTS: There was low prevalence for the instruction on breastfeeding in the first week of life (58.8%, 95% CI 57.5-60.0) and on the introduction of new food in the fourth month care. The prevalence of high-quality in childcare was 42.0% (95% CI 40.5-43.5). The adjusted analysis according to hierarchical model indicated greater probability of this outcome in the Northeast region (PR = 1.17, 95% CI 1.09-1.26), in smaller municipalities (PR = 1.17, 95% CI 1.03-1.33), and in municipalities with 50,000 and 99,000 inhabitants (PR = 1.20, 95% CI 1.09-1.34).CONCLUSIONS: The Northeast region has higher-quality infant care services, which can be explained by the consolidation of the Family Health Strategy in that region.