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Saúde da mulher e da criança: necessidades, comportamentos e atitudes
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Orientador(es)
Resumo(s)
RESUMO - O presente estudo, de tipo coorte, teve como objectivo identificar
necessidades não satisfeitas em saúde da mulher e
da criança no distrito de Viana do Castelo e os factores que
lhes estão associados e conhecer as atitudes e comportamentos
da mulher face à sua saúde e à da criança. Foi
considerada uma amostra aleatória, representativa do distrito
de Viana do Castelo, estratificada por concelho, englobando
um total de 448 mulheres e 453 crianças. Utilizouse
para recolha de dados (i) a consulta dos suportes
informativos referentes à saúde materna (SM) e revisão do
puerpério (RP), planeamento familiar (PF) e saúde infantil
(SI) existentes nos respectivos centros de saúde, (ii) uma
entrevista realizada às mulheres na comunidade. A cobertura
por actividade de vigilância de saúde apresenta valores
bastante elevados (SM, 98,7%; RP, 80,8%; PF, 88,7%;
SI, 99,8%). A análise da qualidade destes cuidados faz
baixar estes valores para SM, 68,4%, RP, 51,6%, PF,
19,0%, e SI, 78,9%. Um esquema de vigilância adequada
em SI está associado negativamente a uma elevada paridade
(paridade ≥ 3, quando comparada com paridade = 1:
odds ratio ajustado de vigilância inadequada (OR) = 5,06;
IC 95%, 2,49-10,31). Pertencer a um grupo etário superior
(grupo etário ≥ 35 anos, quando comparado com grupo
etário = 20-34 anos: OR = 3,93; IC 95%, 1,16-13,25) e ter
uma profissão de operário especializado/semiespecializado
(quando comparada com o quadro superior/médio:
OR = 2,78; IC 95%, 1,25-6,17) constituem factores de risco
de uma baixa cobertura em PF. A não marcação pelo profissional
de saúde da próxima consulta de RP e de SI induz
um risco superior de não comparecer àquelas consultas
(respectivamente OR = 4,89, IC 95%, 3,11-7,71, e OR = 2,41,
IC 95%, 1,16-5,03) quando comparado com o das mulheres/
crianças a quem foi marcada. Os profissionais de saúde
devem conhecer e valorizar os vários factores determinantes
associados às características da mulher (idade, paridade,
escolaridade, actividade profissional) que ainda se apresentam
como factores de risco de vigilância inadequada, bem
como preocupar-se com a marcação da próxima consulta e
a efectivação da consulta de PF no mesmo dia da consulta
de SI, já que com estas simples medidas organizativas
poderão contribuir para uma maior adesão ao cumprimento
destes programas de saúde.
ABSTRACT - The present cohort-type study aimed at identifying unmet needs in woman and child health in Viana do Castelo district, associated factors and woman’s attitudes and behaviours regarding her health and her child’s health. A stratified random sample, representative of the Viana do Castelo district and stratified by municipalities was considered, including a total number of 448 women and 453 children. The procedure of data collection consisted of (i) examining all the information about maternal health (MH) and post-partum follow-up (PPF), family planning (FP) and child health (CH) available at health centres and (ii) interviewing women in the community. The figures of health coverage per activity seem relatively high (MH, 98.7%; PPF, 80.8%; FP, 88.7%; CH, 99.8%). The analysis of the quality of this care brings these figures down to MH, 68.4%, PPF, 51.6%, FP, 19.0%, and CH, 78.9%. An adequate monitoring programme for CH is negatively associated with a high parity (parity ≥ 3, when compared to a parity = 1: inadequate care adjusted odds ratio (OR) = 5.06, CI 95%, 2.49- -10.31). Belonging to an older age group (≥ 35 year-old age group, compared to the 20-34 year-old age group: OR = 3.93, CI 95%, 1.16-13.25) and working as a skilled/semi-skilled worker (as compared to a senior/middle ranking executive position: OR = 2.78, CI 95%, 1.25-6.17) are risk factors for a low coverage in FP. Women/children who did not have their next PPF and CH appointments booked by a health professional are more likely to miss these consultations than women who had their appointments scheduled (respectively OR = 4.89, CI 95%, 3.11-7.71, and OR = 2.41, CI 95%, 1.16-5.03). Health professionals have to be aware of and value the various determinant factors related to woman’s characteristics (age, parity, education, professional activity) that still appear to be risk factors for inadequate care. They also have to be careful about scheduling the next appointment and make sure the FP consultation occurs in the same day as the CH consultation as they can help to increase commitment to the implementation of these health programmes with those simple organizational measures.
ABSTRACT - The present cohort-type study aimed at identifying unmet needs in woman and child health in Viana do Castelo district, associated factors and woman’s attitudes and behaviours regarding her health and her child’s health. A stratified random sample, representative of the Viana do Castelo district and stratified by municipalities was considered, including a total number of 448 women and 453 children. The procedure of data collection consisted of (i) examining all the information about maternal health (MH) and post-partum follow-up (PPF), family planning (FP) and child health (CH) available at health centres and (ii) interviewing women in the community. The figures of health coverage per activity seem relatively high (MH, 98.7%; PPF, 80.8%; FP, 88.7%; CH, 99.8%). The analysis of the quality of this care brings these figures down to MH, 68.4%, PPF, 51.6%, FP, 19.0%, and CH, 78.9%. An adequate monitoring programme for CH is negatively associated with a high parity (parity ≥ 3, when compared to a parity = 1: inadequate care adjusted odds ratio (OR) = 5.06, CI 95%, 2.49- -10.31). Belonging to an older age group (≥ 35 year-old age group, compared to the 20-34 year-old age group: OR = 3.93, CI 95%, 1.16-13.25) and working as a skilled/semi-skilled worker (as compared to a senior/middle ranking executive position: OR = 2.78, CI 95%, 1.25-6.17) are risk factors for a low coverage in FP. Women/children who did not have their next PPF and CH appointments booked by a health professional are more likely to miss these consultations than women who had their appointments scheduled (respectively OR = 4.89, CI 95%, 3.11-7.71, and OR = 2.41, CI 95%, 1.16-5.03). Health professionals have to be aware of and value the various determinant factors related to woman’s characteristics (age, parity, education, professional activity) that still appear to be risk factors for inadequate care. They also have to be careful about scheduling the next appointment and make sure the FP consultation occurs in the same day as the CH consultation as they can help to increase commitment to the implementation of these health programmes with those simple organizational measures.
Descrição
Palavras-chave
saúde da mulher saúde da criança saúde materna planeamento familiar saúde infantil vigilância adequada necessidades em saúde atitudes comportamentos woman health child health maternal health family planning adequate care health care needs attitudes behaviour
Contexto Educativo
Citação
Alves, Odete; Mendonça, Denisa; Maciel-Barbosa, Alcindo - Saúde da mulher e da criança : necessidades, comportamentos e atitudes. Revista Portuguesa de Saúde Pública. ISSN 0870-9025. Vol. 23, Nº. 1 (Janeiro/Junho 2005), p. 69-80
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública