| Silva et al. (2016)1818 Silva CB, Paula CC, Lopes LFD, Harzheim E, Magnago TSBS, Schimith MD. Atenção à saúde de criança e adolescente com HIV: comparação entre serviços. Rev Bras Enferm 2016; 69(3):522-531.
|
Primary health care services (FHS and traditional care centers) and specialist outpatient services for children and adolescents living with HIV |
Primary care attributes
|
The attributes scored higher in the specialist service (6.4) than in the primary health care services (6.1). Neither of the services achieved the minimum quality cut-off score (6.6) for "general items". The lowest-scoring attributes were "family centeredness" and "community orientation". All other attributes, except "services provided" (6.4), achieved the minimum quality cut-off score, indicating strong operationalization of the attributes related to access, longitudinality, comprehensiveness and coordination. Primary care services were not the principal source of care for 56% of the sample. |
| Harzheim et al. (2016)4242 Harzheim E, Hauser L, Pinto LF, Soranz D. Avaliação dos usuários crianças e adultos quanto ao grau de orientação para Atenção Primária à Saúde na cidade do Rio de Janeiro, Brasil. Cien Saúde Colet 2016; 21(5):1399-1408.
|
FHS and mixed health centers |
Primary care attributes
|
There was no significant difference in scores between FHS and mixed model health centers for the "general" and "essential" items. Neither the FHS (6.1) nor the mixed health centers (6.0) achieved the minimum quality cut-off score. The FHS centers scored higher than the mixed health centers. In both types of services, the highest-scoring attributes were "strength of affiliation" (7.6 and 7.4) and "utilization" (7.9 and 7.9). The lowest-scoring attributes were "accessibility" (4.8 and 4.5), "family centeredness" (5.4 and 5.5), and "community orientation" (5.4 and 3.9). |
| Silva e Fracolli (2016)3737 Silva SA, Fracolli LA. Avaliação da assistência à criança na Estratégia de Saúde da Família. Rev Bras Enf 2016; 69(1):47-53.
|
FHS in rural areas |
Primary care attributes
|
The "general score" (6.2) and "essential score" (6.4) failed to achieve the quality cut-off score. The attributes "utilization" (8.0), "longitudinality" (6.7), "care integration" (6.9), and "information systems" (7.0) achieved the quality cut-off score. The attributes "accessibility" (4.9), "available services" (5.2), "services provided" (6.5), "family centeredness" (5.1), and "community orientation" (5.7) failed to achieve the minimum score. The study highlighted that limitations in access may be linked to same-day consultation scheduling problems and difficulties in obtaining guidance by telephone. The poor evaluation of "comprehensiveness" was related to the underprovision of primary care. Low scores for "family centeredness" and "community orientation" indicate that little regard is paid to the opinion of parents/guardians and characteristics of family and community groups. FHS was the main care source in 56.3% of the sample. |
| Oliveira e Veríssimo (2015)2121 Oliveira VB, Veríssimo MD. Assistência à saúde da criança segundo suas famílias: comparação entre modelos de Atenção Primária. Rev Esc EnfermUSP 2015; 49(1):30-36.
|
FHS and traditional care centers in urban areas |
Primary care attributes
|
All attributes scored higher in the FHS centers than in the traditional health centers. FHS centers showed stronger operationalization (6.6) than traditional health centers (3.9). In the FHS centers, the attributes that failed to achieve the quality cut-off score were "accessibility" (5.1), "longitudinality" (5.4), "information systems" (6.3), "available services" (6.2), and "community orientation" (5.6). In the traditional health centers, none of the attributes achieved the minimum quality cut-off score. The factors that explained low scores in both types of services were: poor access and wait times, lack of availability of information registers, lack of access to child health care services, and insufficient knowledge about the family and the community. Despite satisfactory results for the FHS, the study highlighted the need to review child health care actions. |
| Araújo et al. (2014)3838 Araújo JP, Viera CS, Toso BR, Collet N, Nassar PO. Avaliação dos atributos de orientação familiar e comunitária na saúde da criança. Acta Paul Enferm 2014; 27(5):440-446.
|
Primary health care services |
Community orientation and family centeredness
|
The attributes "family centeredness" (4.4) and "community orientation" (5.1) failed to achieve the quality cut-off score. The study highlighted that services adopt a predominantly traditional care approach centered on the individual rather than the family/community. |
| Ferrer et al. (2014)2020 Ferrer AP, Brentani AV, Sucupira AC, Navega AC, Cerqueira ES, Grisi SJ. The effects of a people-centred model on longitudinality of care and utilization pattern of healthcare services-Brazilian evidence. Health Policy Planning 2014; 29(2):107-113.
|
FHS and traditional care centers |
Longitudinality of care
|
The attribute "longitudinality" failed to achieve the quality cut-off score (4.9). FHS services scored higher than traditional care centers for this attribute. Around 66% of FHS patients considered the attribute to be adequate. |
| Mesquita Filho et al. (2014)3939 Mesquita Filho M, Luz BS, Araújo CS. A Atenção Primária à Saúde e seus atributos: a situação das crianças menores de dois anos segundo suas cuidadoras. Cien Saúde Colet 2014; 19(7):2033-2046.
|
Primary health care services |
Primary care attributes
|
The study reported weak operationalization of primary care attributes. The "general score" was 5.2 and 85.0% of the evaluations were negative. The only attribute to achieve the quality cut-off score was "longitudinality" (7.8). The lowest-scoring attributes were "accessibility" (4.7) and "available services" (2.9), receiving low scores from 91.5% and 94.6% of service users, respectively. Coordination of primary health care scored higher among child FHS service users than in those registered in traditional primary care centers (PR = 0.34). Around 77.1% of service users reported that the FHS was their preferred service for child care. |
| Marques et al. (2014)1919 Marques AS, Freitas DA, Alves Leão CD, Oliveira M, Ketllin S, Pereira MM, Caldeira AP. Atenção Primária e saúde materno-infantil: a percepção de cuidadores em uma comunidade rural quilombola. Cien Saúde Colet 2014; 19(2):365-371.
|
FHS in a rural quilombola community |
Primary care attributes
|
The "general items" failed to achieve the quality cut-off score (6.4). The attributes "utilization" (9.1) and "information systems" (6.9) achieved the quality cut-off score. The lowest-scoring attributes were "accessibility" (4.8) and "family centeredness" (3.8). The low primary care attribute scores suggest there is a gap between actual and desired actions. The FHS was the preferred service for child care for more than 80% of the service users. |
| Perez et al. (2014)1616 Perez LG, Sheridan JD, Nicholls AY, Mues KE, Saleme PS, Resende JC, Ferreira JA, Leon JS. Professional and community satisfaction with the Brazilian family health strategy. Rev Saúde Públ 2013; 47(2):403-413.
|
FHS |
Service quality, health professional communication, and care problems |
Professionals gave higher scores for accessibility and care quality than service users. Parents/guardians and professionals identified similar weaknesses (lack of access, staff shortages, and underqualified professionals) and strengths (communication between community health agents, provision of educational material, and pediatric care). The most commonly reported problem was staff shortages. The majority of professionals highlighted insufficient training in terms of number, content, and methods. In general, both professionals and parents/guardians reported being satisfied with the services, despite the failings. Parent/guardian satisfaction/dissatisfaction tended to be linked to the health professionals and access to health promotion and disease prevention services, respectively. |
| Rocha e Pedroza (2013)2626 Rocha AC, Pedraza DF. Acompanhamento do crescimento infantil em unidades básicas de saúde da família do município de Queimadas, Paraíba, Brasil. Texto Contexto-Enferm 2013; 22(4):1169-1178.
|
FHS in urban and rural areas |
Developmental follow-up structure and process |
The evaluation of care structure highlighted that the main limitation was staff shortages. With regard to process, 60% of the nurses had not received training for care actions and over 60% reported that consultations over the last three months were not recorded on the children's health cards. 75% of care delivery was based on clinical protocols. The findings show a lack of consolidation of developmental follow-up in primary health care services. |
| Modes e Gaíva (2013)4343 Modes PSSA, Gaíva MA. Structure of children's basic health units: descriptive study. Online Braz J Nur 2013; 12(3):471-481.
|
Primary health care services in urban and rural areas |
Structure of child care centers |
The results show that 61.5% of the care centers did not have reception or waiting rooms. However, all centers had nurse and doctor consulting rooms, vaccination rooms, and dispensing areas. Shortages of materials were reported in all centers. Availability of standard medications and SINAN and SISVAN forms was reported to be good. The findings showed a lack of SIAB forms and vaccination cards. Only 53.8% of the health professionals had computers without access to the internet. The care structure was not in line with the minimum standards set by the Ministry of Health. |
| Modes e Gaíva (2013)4040 Modes PS, Gaiva MA. Satisfação das usuárias quanto à atenção prestada à criança pela rede básica de saúde. Esc Anna Nery Rev Enferm 2013; 17(3):455-465.
|
Primary health care services |
Child health care processes and outcomes |
With regard to process, 60.6% of children received developmental follow-up from doctors and nurses. The least tested parameter was blood pressure. The professionals that most used the child health card are nurses; however, the cards were not filled out properly. Around 75.6% of mothers understood the topics discussed with the professionals and 62.2% reported that they had the opportunity to raise their doubts and concerns. The evaluation of care quality and health professionals was fair and good, respectively. Level of satisfaction was associated with guidance on prevention of accidents, violence, and respiratory problem, the opportunity to discuss concerns during the consultation, and free-of-charge medication. |
| Sales et al. (2013)1515 Sales ML, Ponnet L, Campos CE, Demarzo MM, de Miranda CT. Qualidade da atenção à saúde da criança na estratégia saúde da família. J Human Growth Dev 2013; 23(2):151-156.
|
FHS |
Child care quality standards recommended by the AIQ |
The quality standards were: elementary (84.1%), in development (69.7%), consolidated (58.6%), good (82.1%), and advanced (47.7%). The findings demonstrated that the quality of child health care showed basic development patterns. The results also show that the health teams that had been working for less time showed the best results. |
| Machado et al. (2012)2424 Machado MM, Bezerra Filho JG, Machado MD, Lindsay AC, Magalhães FB, Gama ID, Cunha AJ. Características dos atendimentos e satisfação das mães com a assistência prestada na atenção básica a menores de 5 anos em Fortaleza, Ceará. Cien Saúde Colet 2012; 17(11):3125-3133.
|
FHS |
Access, care and satisfaction |
Access to health services: 91.1% of children had had consultations in the last 6 months; 77.4% used the health center closest to their home; 72.6% reported an average waiting time of at least two hours; and 51.7% received visits from a community health agent. Treatment: 74.0% reported that their last consultation was with a doctor; 57.7% knew the name of the health professional that saw them; and 63.7% of professionals called the mother/child by their name. Around two-thirds of the mothers reported being satisfied with the last consultation. The main associated factors were: the fact that the professional calls the mother/child by their name; same-day consultation; and provision of entertainment for children in the waiting room. One of the strengths of the services highlighted by the study was ease of access to services. Weaknesses included the adoption of a curative care model, with little emphasis on health promotion and disease prevention. Service user satisfaction was associated with the patient- health professional relationship. |
| Leão et al. (2011)2222 Leão CD, Caldeira AP, Oliveira MM. Atributos da atenção primária na assistência à saúde da criança: avaliação dos cuidadores. Rev Bras Saúde Matern Infant 2011: 11(3):323-334.
|
FHS and other child care services |
Primary care attributes
|
The FHS scored higher than other care services. The differences between the two types of service were significant. Neither the FHS (6.4) nor the other services (5.7) achieved the quality cut-off score for "general items". Both services obtained low scores for "accessibility", "available services", "family centeredness", and "community orientation". The FHS was the preferred service for child care for 77.7% of service users. |
| Luhm et al. (2011)2525 Luhm KR, Cardoso MR, Waldman EA. Cobertura vacinal em menores de dois anos a partir de registro informatizado de imunização em Curitiba, PR. Rev Saúde Publ 2011; 45(1):90-98.
|
Primary health care services |
Vaccination coverage, profile of service users, and utilization of primary care services |
Child vaccination coverage ranged from 95.3% at age 12 months to 90.3% at age 24 months. Around 98% of the immunization records were computerized. The dose underreporting and duplication rate was 11% and 20.6%, respectively. Coverage was greater among children permanently registered in the services and those who had had 3 or more consultations, and in centers with complete health teams. Vaccination coverage was high and even. Affiliation with services was an important factor in achieving these results. |
| Leão e Caldeira (2011)4444 Leão CD, Caldeira AP. Avaliação da associação entre qualificação de médicos e enfermeiros em atenção primária em saúde e qualidade da atenção. Cien Saúde Colet 2011; 16(11):4415-4423.
|
FHS |
Association between primary care attributes and the qualification of FHS doctors and nurses |
The findings show that health teams with professionals who had done family health or family and community medicine residencies obtained higher primary care attribute scores. |
| Costa et al. (2011)1717 Costa GD, Cotta RM, Reis JR, Ferreira MD, Reis RS, Franceschini SD. Avaliação da atenção à saúde da criança no contexto da Saúde da Família no município de Teixeiras, Minas Gerais, Brasil. Cien Saúde Colet 2011; 1:3229-3240.
|
FHS |
Structure, process, and outcome domains |
Care quality was fair for all domains. With regard to structure, the study highlighted limitations in physical facilities, material shortages, lack of protocols, among others. With regard to process, the findings highlight that care was limited and fragmented, a focus on curative care, and inadequate training for health promotion and disease prevention. The findings also highlighted advances in receptiveness, limitations with regard to the development of health promotion and disease prevention, and advances in the reorganization of child care. |
| Ribeiro et al. (2010)4141 Ribeiro LD, Rocha RL, Ramos-Jorge ML. Acolhimento às crianças na atenção primária à saúde: um estudo sobre a postura dos profissionais das equipes de saúde da família. Cad Saúde Pública 2010; 26(12):2316-2322.
|
FHS |
Receptiveness of child primary health care |
The findings show that the FHS was the preferred service for child care for 77.6% of respondents, principally due to the patient-health care professional relationship. With respect to receptiveness, 74.2% of service users reported that they believed that the professionals understood what they said and asked; 79.2% responded questions according to their understanding; 77.2% were able to talk to the professionals whenever they needed to; and 73,2% felt comfortable talking to the professionals. Receptiveness was considered satisfactory. |
| Caldeira et al. (2010)2323 Caldeira AP, Oliveira RM, Rodrigues OA. Qualidade da assistência materno-infantil em diferentes modelos de Atenção Primária. Cien Saúde Colet 2010; 15(Supl. 2):3139-3147.
|
FHS and traditional care centers |
Child health care process |
FHS centers scored higher for all variables. Despite performing better than other services, the care FHS services were inadequate in terms of provision, quality, and new services. |
| Figueiras et al. (2003)2727 Figueiras ACM, Puccini RF, Silva EM, Pedromônico MR. Avaliação das práticas e conhecimentos de profissionais da atenção primária à saúde sobre vigilância do desenvolvimento infantil. Cad Saúde Públ 2003; 19(6):1691-1699.
|
FHS and traditional care centers |
Knowledge and practice of child developmental surveillance among professionals |
Doctors and nurses working in traditional health centers had better knowledge of child developmental surveillance than those in FHS centers. With respect to practices, only 21.8% of mothers reported having been asked about the development of their children, 27.6% stated that the professional had asked about or observed their child's development, and 14.4% had received guidance on how to stimulate their child. The study concludes that primary care professionals are not adequately trained for child developmental surveillance, meaning that surveillance is not carried out satisfactorily. |
Thumbnail
Thumbnail
