Care trajectories of users with precursor lesions of cervical cancer by primary health care in a health region: free transit, length and stop points

Abstract

The article aims to evaluate the access and organization of Primary Health Care (PHC) actions using cervical cancer (CCU) as a tracer event. Assistance trajectories of women with diagnosis of high grade cervical lesion were constructed, from Basic Health Units and Family Health Units, urban and rural areas, in the interior municipalities and at the headquarters of a health region of the Bahia. Women indicate difficulty accessing medical consultations in PHC, especially in rural areas. In addition to the obstacles to cytopathological scheduling, most patients report not being called to accomplish it and do not participate in educational activities on the issue. The control actions of the CCU in PHC are restricted to cytopathology, evaluation of the outcome and referral to specialized care, without follow-up care and with failures in professional-user communication. Barriers to access to PHC in general and to CCU control related to the scope of actions were identified, mainly in the units located in the municipality with less availability of services, in the rural area and in the traditional Basic Health Units.

Keywords:
Primary Health Care; comprehensive health care; uterine cervical neoplasms