Avaliação da atenção à saúde da criança na Estratégia Saúde da Família: uma abordagem dos indicadores de qualidade na percepção dos enfermeiros

Abstract

Primary Health Care (PHC) stands out as the central and structuring axis of health systems, with a coordinating role for the Health Care Network. PHC represents the users' first contact with the health system and the activities developed are guided by the principles of universal access, integral care, accessibility and humanization. The Family Health Strategy (FHS) represents the main strategy for the expansion and consolidation of PHC in implementing the principles and guidelines of the Unified Health System. Assessing the PHC orientation of each health service or FHS team allows production knowledge of its effectiveness and quality. Objectives: To evaluate the health care of the child in the FHS of a county in the interior of Minas Gerais. Specifically: to assess the presence and extent of essential attributes and derivatives of PHC in relation to comprehensive child health care; identify and describe the specific quality indicators of children under two years in the FHS, according to the nurses' perception; evaluate the nurses' perception of quality indicators; verify conformities and nonconformities of the quality indicators identified with the recommendations of the Ministry of Health. Results: Most of the Primary Health Care attributes presented satisfactory scores, such as Longitudinality, Coordination - Care Integration, Coordination - Information Systems, Integrality - Available Services and Integrality - Services Provided. Accessibility, Family Guidance and Comorbidity Guideline received scores lower than 6.6 and were considered unsatisfactory. The General (6.53) and Essential scores (6.69) reached insatiable and satisfactory values, respectively. Conclusions: In the nurses' perception, the FHS in the county is a regular source of attention and provider of health practices based on the majority of PHC attributes. Attributes that were not considered present or of poor quality indicate weaknesses in PHC services. The FHS nurses' perspective also allowed us to infer that health care indicators can have different meanings. In the FHS, the medical consultation of Childcare as the main activity performed in the care of children under two years. Qualitative research also allowed us to understand that there is no consensus or standardization of the use of indicators in the health care of children and that there are still difficulties in adopting indicators during nurses' professional practice.