Child Health Care Organization: Assessment of Primary Care Services in the State of São Paulo, Brazil
METHODS: The goal of this study is to assess the organization of child health care in Primary Care Services located in the state of São Paulo, Brazil, by means of a questionnaire self-answered by the teams (QualiAB). This took place in 2010 in services located in 585 municipalities (90.6% of state municipalities), the majority of which under 100.000 inhabitants.
RESULTS: Out of a universe of 2,735 services, 2,687 provide health care to children. We studied 31 issues concerning child health care. Among the actions aimed at children it is worth mentioning: medical consultation (98%); nursing consultation (80.3%); vaccination (77.6%); educational actions in the community (93.4%); odontological care for babies (36.6%), odontological care for children up to 6 year old (46,9%) and for schoolchildren (54.4%); clinical samples collection for laboratory tests (68%) and drug dispensation (85.1%). Among the actions planned in child health care some conditions are tackled less frequently, such as schoolchildren health (33.9%), child respiratory infections (57%) and violence (30.8%). Other conditions, more traditional, are tackled more often, like breastfeeding (87.3%), childcare (87.7%) and malnourishment (73.9%). Of all services 13.7% report congenital syphilis cases over the last 3 years, of which 39.4% do not offer treatment for pregnant women with syphilis in the unit, despite performing their diagnosis.
CONCLUSIONS: We conclude that in spite of the broad access to child health care provided by public Primary Care Services, an insufficient care is taken of preventable diseases such as congenital syphilis and respiratory infections, and newer demand such as care of schoolchildren or children suffering violence is often not met.