The Brazilian government has been implementing health care policies that emphasize primary health care since 1988. Yet, to date, no study has examined the effects of the policies on children. A cohort study assessed the effects of primary care on the health status of 85 twelve-month-old infants residing in a neighborhood of São Paulo. Infants were classified as "healthy" if they had been ill no more than three times during the first year, or "ill" if they had been ill at least four times. Primary pediatric care was considered either "continuous" or "fragmented". Continuous care was defined as starting care in the first month after birth and following the guidelines of the Health Secretariat of the City as to the number and interval of medical appointments. Otherwise, the infant was defined as receiving fragmented care. Forty percent of infants were classified as ill, and 89.4% were classified as receiving fragmented care. A bivariate analysis showed an association between fragmented care and illness (p=0.003). After adjusting for other variables, health status was predicted by maternal age and number of persons per room. The results show a relationship between low socio-economic status, inadequate access to care, and illness. The transition towards an equitable primary care system in Brazil is slow and challenging.
Epidemiology; Health care; Infant health; Health status; Brazil
