Ioná Carreno

A rotatividade de enfermeiros e médicos: um impasse na implementação da Estratégia de Saúde da Família

The research analyzed the causes for turnover rate of doctors and nurses in family health strategy teams with at least two years of implementation on March 2006 in Vale do Taquari, Rio Grande do Sul State. It is a quantitative and qualitative study identifying 31 teams in 25 towns, and the turnover rate was established by year from 1999 to 2005 by professional category. There was no turnover for doctors and nurses in 1999 and 2000. Doctor turnover was 5.9% in 2002; 32.1% in 2003; 25.8% in 2004; and 64.5% in 2005. Regarding nurses, it was 27.7% in 2001; 47% in 2002; 17.8% in 2003; 41.9% in 2004; and 22.6% in 2005. The analysis of semi-structured interviews with 7 doctors and 7 nurses appointed as main causes for turnover: poor work links, fragmented education, authoritarian way of managing, no links with the community, and poor work conditions. Thus, it is necessary to make changes regarding labor links, work conditions, and education for health workers and managers, seeking for the integrality in health practices.

As parteiras e o cuidado com o nascimento

En este estudo hemos tenido el objetivo de conocer el cuidado con el nacimiento hecho por parteras, en la mitad del siglo pasado. Es un estidio de abordaje cualitativo, ulizandose la analisis de contenido. Fueron entrevistadas cuatro partera. Han surgido cinco categorias: motivacion para ser partera; aprendizaje del trabajo de ser partera; contextualizacion del trabajo de partera; desarrollo del cuidado; compensacion del trabajo. Las parteras han buscado la ocupacion por una necesidad institucional y de trabajo. Han aprendido en cursos y con la practica. En las viviendas las condiciones eran precarias y realizaban la mayoria de los partos en el hospital. Seguian los cuidados indispensables a la madre y al hijo. Cuentan que tenian mucha paciencia para que el parto fuera normal. Han realizado su trabajo con desprendimiento, pues la compensacion venia por el reconocimiento social.This study aimed at knowing the care in childbirths conducted by midwives by the middle of 20th century It is a study of qualitative approach using as reference the Content Analysis. Four midwives were interviewed. Five categories emerged: Motivation to be a midwife; learning to be a midwife; positioning the midwifes work; developing care; work compensation. Midwives sought this occupation for institutional and job need. They learned the work in courses and practice. At home, conditions were poor, and in hospitals, they conducted the majority of the childbirth. They took the necessary care for mother and child. They have reported to be patient so that mothers could have normal childbirth. They conducted with selflessness because social recognition was their compensation.

Temporal evolution and spatial distribution of maternal death

OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution. METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008. RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding. CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.

Perfil epidemiológico das mortes maternas ocorridas no Rio Grande do Sul, Brasil: 2004-2007

This study analyzed the epidemiological profile of maternal deaths that occurred from 2004 to 2007 in Rio Grande do Sul, by means of Maternal Mortality Rates and Specific Maternal Mortality Ratio. Data was obtained from the Health Information System database and 323 maternal deaths were identified. In order to analyze indicators, Poisson regression and statistical tests were carried out. A decrease in maternal mortality rates (0.98) was identified, although there was no difference in estimate measures (CI95% 0.87-1.10). Maternal deaths were more frequent in women who were over 40 years old, had low schooling, black skin and no partners. The period of highest risk of maternal death was during pregnancy and birth, and the main direct causes were arterial hypertension and bleeding. Maternal mortality is an important issue to be confronted and reduced, given most maternal deaths could have been avoided.

Análise da utilização das informações do Sistema de Informação de Atenção Básica (SIAB): uma revisão integrativa

This paper aimed to identify instances of the use of data from the Primary Health Care Information System in the existing scientific literature. This study is an Integrative Literature Review and the search for articles was performed in May, 2013 in the Virtual Healthcare Library (MedLine, Lilacs and SciELO), considering publications from 2008 to 2012. The search for articles initially located 164 texts, though after applying the inclusion and exclusion criteria, this review concentrated on 12 articles. The main results showed that there are fragilities like the use of the form just for the record and the insufficient training of the teams. However, the positive aspect is that the Primary Health Care Information System is the leading source of health information and statistics, and that its information can and must be used for health planning activities. Thus, it is an information system that assists municipal management and the actions in health of its teams, alerting the community to the need for care of individual health.

The importance of waste from healthcare services for teachers, students and graduates of the healthcare sector

This study aimed to explore the perception healthcare sector teachers, students and graduates from two institutions of higher learning in Rio Grande do Sul, on the generation of waste from healthcare services. It used a qualitative research approach, performed with 13 teachers, 18 students and 12 healthcare professionals, who were collected through a focus group. The main results showed there is a perception toward the importance of proper segregation and disposal of Healthcare Service Waste, also there is a lack of concern for the reduction of these wastes. Therefore, the issue requires a broader understanding of the environment, with a view of planetary sustainability, exposing needs to provide the healthcare professionals with knowledge and awareness of the importance of handling these types of waste.

A importância dos resíduos de serviços de saúde para docentes, discentes e egressos da área da saúde

This study aimed to explore the perception healthcare sector teachers, students and graduates from two institutions of higher learning in Rio Grande do Sul, on the generation of waste from healthcare services. It used a qualitative research approach, performed with 13 teachers, 18 students and 12 healthcare professionals, who were collected through a focus group. The main results showed there is a perception toward the importance of proper segregation and disposal of Healthcare Service Waste, also there is a lack of concern for the reduction of these wastes. Therefore, the issue requires a broader understanding of the environment, with a view of planetary sustainability, exposing needs to provide the healthcare professionals with knowledge and awareness of the importance of handling these types of waste.

Discutir saúde e imigração no contexto atual de intensa mobilidade humana

Este artigo aborda as relacoes entre imigracao e saude no Brasil, partindo de uma abordagem historica que busca contextualizar o debate no pais desde o seculo XIX ate os dias atuais. A problematizacao dessas relacoes destaca os desafios das politicas sociais de acolhimento e integracao dos imigrantes no mundo globalizado. Por meio da revisao bibliografica sobre imigracao e saude no contexto brasileiro e internacional, buscamos prioridades que se impoem a saude coletiva em face da intensa mobilidade humana atual. As desigualdades socioeconomicas marcam a experiencia de parte dos imigrantes, expondo estas populacoes a uma maior vulnerabilidade, adoecimento e menor qualidade de vida. Apontamos a necessaria promocao da equidade de acesso a saude, prevencao contra a discriminacao, ampliacao das politicas publicas, formacao dos profissionais e oferta de servicos adaptados, abordando a tematica das migracoes como determinante social de saude.

Midwives and care in childbirth

En este estudo hemos tenido el objetivo de conocer el cuidado con el nacimiento hecho por parteras, en la mitad del siglo pasado. Es un estidio de abordaje cualitativo, ulizandose la analisis de contenido. Fueron entrevistadas cuatro partera. Han surgido cinco categorias: motivacion para ser partera; aprendizaje del trabajo de ser partera; contextualizacion del trabajo de partera; desarrollo del cuidado; compensacion del trabajo. Las parteras han buscado la ocupacion por una necesidad institucional y de trabajo. Han aprendido en cursos y con la practica. En las viviendas las condiciones eran precarias y realizaban la mayoria de los partos en el hospital. Seguian los cuidados indispensables a la madre y al hijo. Cuentan que tenian mucha paciencia para que el parto fuera normal. Han realizado su trabajo con desprendimiento, pues la compensacion venia por el reconocimiento social.This study aimed at knowing the care in childbirths conducted by midwives by the middle of 20th century It is a study of qualitative approach using as reference the Content Analysis. Four midwives were interviewed. Five categories emerged: Motivation to be a midwife; learning to be a midwife; positioning the midwifes work; developing care; work compensation. Midwives sought this occupation for institutional and job need. They learned the work in courses and practice. At home, conditions were poor, and in hospitals, they conducted the majority of the childbirth. They took the necessary care for mother and child. They have reported to be patient so that mothers could have normal childbirth. They conducted with selflessness because social recognition was their compensation.

Debating health and migrations in a context of intense human mobility

Este artigo aborda as relacoes entre imigracao e saude no Brasil, partindo de uma abordagem historica que busca contextualizar o debate no pais desde o seculo XIX ate os dias atuais. A problematizacao dessas relacoes destaca os desafios das politicas sociais de acolhimento e integracao dos imigrantes no mundo globalizado. Por meio da revisao bibliografica sobre imigracao e saude no contexto brasileiro e internacional, buscamos prioridades que se impoem a saude coletiva em face da intensa mobilidade humana atual. As desigualdades socioeconomicas marcam a experiencia de parte dos imigrantes, expondo estas populacoes a uma maior vulnerabilidade, adoecimento e menor qualidade de vida. Apontamos a necessaria promocao da equidade de acesso a saude, prevencao contra a discriminacao, ampliacao das politicas publicas, formacao dos profissionais e oferta de servicos adaptados, abordando a tematica das migracoes como determinante social de saude.