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The impact of economic crisis on children's health: analysis of the perceptions of migrant and native families'users of primary health care in Amadora
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Introdução: A crise económica afectou de forma diferente a saúde das crianças em vários países do mundo. Em Portugal, a crise contribuiu para o aumento do desemprego e cortes salariais no seio das famílias; aumentou a pobreza infantil e reduziu os benefícios sociais, afectando o bem-estar, físico, psicológico e emocional das crianças. Em Portugal, escassos são os estudos que analisam o impacto da crise económica na saúde infantil, daí a importância do presente estudo para suprir o défice de pesquisa nesta área, igualmente este estudo irá contribuir para a melhoria das políticas de saúde existentes por forma a prevenir impactos de futuras crises económicas na saúde.
Objectivo: Comparar os efeitos da crise económica na saúde infantil através das percepções dos cuidadores migrantes e nativos de crianças utentes do Agrupamento dos Centros de Saúde da Amadora (ACES da Amadora).
Desenho: Estudo observacional e transversal, com abordagem quantitativa.
Local de estudo: O estudo foi realizado de 8 de Janeiro a 15 de Março de 2018 nas 9 unidades de cuidados de saúde primários do ACES da Amadora.
Instrumento: a recolha de dados foi feita por meio de um questionário semiestruturado; a amostra foi composta por 507 participantes, seleccionados através de uma amostragem por conglomerados em dois estágios, em que as unidades de cuidados de saúde primária eram os conglomerados. Foram aplicadas estatísticas descritivas, o Modelo de Regressão Logística, testes não paramétricos (qui-quadrado e Mann Whitney) e teste paramétrico (teste t) em função de cada objectivo e adequabilidade da variável.
Resultados: dos 507 participantes, 168 (33,1%) são migrantes, 312 (61,5%) são portugueses e 27 (5,3%) não revelaram a nacionalidade. A percepção sobre os efeitos da crise económica na saúde das crianças está associada à idade (OR1,043; IC 90% 1,014 - 1,072) e nacionalidade (OR 1.418; IC 90% 0.959 - 2.288) em que os cuidadores mais velhos e os nativos percebem mais os efeitos da crise económica. Porém, tanto os migrantes assim como os nativos percebem que a crise não afectou o acesso aos serviços de saúde. Ambos grupos referiram ter dificuldades financeiras que os restringiram de pagar despesas comuns.
Limitações: participantes foram questionados sobre um evento passado, é possível que viés de memória para recordar evento dos 4 anos atrás tenham ocorrido. Os pais de crianças não registadas no ACES da Amadora não foram entrevistadas, apesar delas fazerem parte do mesmo município e também barreiras de comunicação durante as entrevistas foram encontrados.
Conclusão: os resultados do nosso estudo mostram que a crise económica afectou mais os cuidadores mais velhos e os nativos. Contudo, ambos grupos afirmaram que não sofreram limitações no acesso aos serviços de saúde.
Background: The economic crisis affected differently children’s health in many countries of the world. In Portugal it contributed to increase children poverty, family unemployment, cuts on wages and social benefits, hence affecting on children physical, emotional and behavioural health and wellbeing. There is a lack of studies in Portugal that analyse the impact of economic crisis on children health, therefore this study will help to enhance existing policies on health and to prevent future impacts of economic crisis on health. Objective: To compare the effects of the economic crisis on child health through the perceptions of migrant and native caregivers of children attending Amadora Group of Primary Care Centres (ACES-Amadora). Design: Observational and cross-sectional study with a quantitative approach. Setting: The study was conducted from January 8th to March 15th, 2018 in 9 primary health care units of the ACES-Amadora. Measurements: Data were collected through a semi-structured questionnaire; 507 participants were selected through two-stage cluster sampling; where clusters correspond to groups of primary health care units. Descriptive statistics, multivariate logistic regression, non-parametric (chi-square and Mann Witney U test) and a parametric test (t-test) were performed. Results: From the 507 participants, 168 (33.1%) were migrants, 312 (61.5%) were Portuguese native and 27 (5.3%) did not reveal their nationality. Caregivers perception on the effect of economic crisis on child health is associated with age (OR1.043; 90% CI 1.014 - 1.072) and nationality (OR 1.418; 90% CI 0.959 - 2.288). Migrants and non-migrants perceive that the crisis did not affect access to health services in general. Both groups referred that one of the effects of the crisis were restrictions in payment of common expenses. Limitations: Participants were asked about a past event and memory bias to recall events in the last 4 years might have occurred. Parents of children not registered in the ACES-Amadora were not interviewed despite children be covered by this municipality. Communication barriers during the interviews were faced. Conclusion: Findings of our study shows that the economic crisis affected more the older and native caregivers. However, both groups asserted that they did not suffer any limitation in the access of health services.
Background: The economic crisis affected differently children’s health in many countries of the world. In Portugal it contributed to increase children poverty, family unemployment, cuts on wages and social benefits, hence affecting on children physical, emotional and behavioural health and wellbeing. There is a lack of studies in Portugal that analyse the impact of economic crisis on children health, therefore this study will help to enhance existing policies on health and to prevent future impacts of economic crisis on health. Objective: To compare the effects of the economic crisis on child health through the perceptions of migrant and native caregivers of children attending Amadora Group of Primary Care Centres (ACES-Amadora). Design: Observational and cross-sectional study with a quantitative approach. Setting: The study was conducted from January 8th to March 15th, 2018 in 9 primary health care units of the ACES-Amadora. Measurements: Data were collected through a semi-structured questionnaire; 507 participants were selected through two-stage cluster sampling; where clusters correspond to groups of primary health care units. Descriptive statistics, multivariate logistic regression, non-parametric (chi-square and Mann Witney U test) and a parametric test (t-test) were performed. Results: From the 507 participants, 168 (33.1%) were migrants, 312 (61.5%) were Portuguese native and 27 (5.3%) did not reveal their nationality. Caregivers perception on the effect of economic crisis on child health is associated with age (OR1.043; 90% CI 1.014 - 1.072) and nationality (OR 1.418; 90% CI 0.959 - 2.288). Migrants and non-migrants perceive that the crisis did not affect access to health services in general. Both groups referred that one of the effects of the crisis were restrictions in payment of common expenses. Limitations: Participants were asked about a past event and memory bias to recall events in the last 4 years might have occurred. Parents of children not registered in the ACES-Amadora were not interviewed despite children be covered by this municipality. Communication barriers during the interviews were faced. Conclusion: Findings of our study shows that the economic crisis affected more the older and native caregivers. However, both groups asserted that they did not suffer any limitation in the access of health services.
Descrição
Palavras-chave
Saúde pública Saúde e desenvolvimento Crise económica Migração Saúde infantil
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical