Michelle Nepomuceno Souza

Desigualdade socioeconômica no acesso aos serviços de saúde no Brasil: um estudo comparativo entre as regiões brasileiras em 1998 e 2008

Este artigo mensura a desigualdade socioeconomica no acesso aos servicos de saude no Brasil e regioes, em 1998 e 2008. A analise controla por fatores predisponentes, capacitantes e de necessidade. Os resultados mostram um aumento das taxas de utilizacao e reducao das desigualdades no cuidado primario, especialmente entre individuos sem plano sugerindo melhora nos servicos publicos. A excecao e a utilizacao de servicos odontologicos, que ainda apresenta desigualdade elevada e maior utilizacao entre individuos com plano. Para o indicador de problema de acesso, observa-se ainda desigualdade favoravel aos ricos. Ao controlar para plano de saude, essa desigualdade se reduz consideravelmente.

A equidade na cobertura da Estratégia Saúde da Família em Minas Gerais, Brasil

A Estrategia Saude da Familia (ESF) tem papel relevante na prevencao e no acompanhamento das familias no Sistema Unico de Saude. O presente estudo tem como objetivo analisar a equidade na cobertura desses servicos ofertados na area urbana de Minas Gerais, Brasil. A pesquisa analisa diversos marcadores considerando quatro grupos-alvo: mulheres, gestantes, criancas e idosos, sendo representativa por macrorregiao de saude. Foram investigados em 2012, 6.797 domicilios, sendo entrevistados 5.820 mulheres, 1.758 criancas e 3.629 idosos. Para analisar a equidade, foram construidas taxas de cobertura da ESF por classe de riqueza e estimados indices e curvas de concentracao. Os resultados revelam que a ESF e uma politica equitativa. Os indicadores mostram que os domicilios mais pobres apresentam maiores taxas de visitacao da ESF. Considerando a populacao residente nas areas adscritas as equipes de saude, o nivel de cobertura e bastante elevado: 88% da populacao investigada receberam pelo menos uma visita dos profissionais da ESF nos ultimos 12 meses, o que resulta em indices de concentracao perto de zero.The Family Health Strategy (FHS) plays an important role in prevention and in monitoring families in the Brazilian Unified National Health System. This study aims to analyze equity in the coverage of these services in the urban areas of Minas Gerais State, Brazil. The research is unprecedented and analyzes several markers for four target groups: women, pregnant women, children, and the elderly. The study is representative of the various health macro-regions. In 2012, 6,797 households were surveyed, with 5,820 women, 1,758 children, and 3,629 elderly. To analyze equity, FHS coverage rates were calculated according to family income, and concentration indices and curves were estimated. The results show that the FHS is an equitable policy. The indicators show that poorer households have higher visitation rates under the FHS. Coverage of the eligible population is quite high: 88% of households received at least one visit from FHS professionals in the previous 12 months, resulting in a concentration index near zero.

Equity in coverage by the Family Health Strategy in Minas Gerais State, Brazil

A Estrategia Saude da Familia (ESF) tem papel relevante na prevencao e no acompanhamento das familias no Sistema Unico de Saude. O presente estudo tem como objetivo analisar a equidade na cobertura desses servicos ofertados na area urbana de Minas Gerais, Brasil. A pesquisa analisa diversos marcadores considerando quatro grupos-alvo: mulheres, gestantes, criancas e idosos, sendo representativa por macrorregiao de saude. Foram investigados em 2012, 6.797 domicilios, sendo entrevistados 5.820 mulheres, 1.758 criancas e 3.629 idosos. Para analisar a equidade, foram construidas taxas de cobertura da ESF por classe de riqueza e estimados indices e curvas de concentracao. Os resultados revelam que a ESF e uma politica equitativa. Os indicadores mostram que os domicilios mais pobres apresentam maiores taxas de visitacao da ESF. Considerando a populacao residente nas areas adscritas as equipes de saude, o nivel de cobertura e bastante elevado: 88% da populacao investigada receberam pelo menos uma visita dos profissionais da ESF nos ultimos 12 meses, o que resulta em indices de concentracao perto de zero.The Family Health Strategy (FHS) plays an important role in prevention and in monitoring families in the Brazilian Unified National Health System. This study aims to analyze equity in the coverage of these services in the urban areas of Minas Gerais State, Brazil. The research is unprecedented and analyzes several markers for four target groups: women, pregnant women, children, and the elderly. The study is representative of the various health macro-regions. In 2012, 6,797 households were surveyed, with 5,820 women, 1,758 children, and 3,629 elderly. To analyze equity, FHS coverage rates were calculated according to family income, and concentration indices and curves were estimated. The results show that the FHS is an equitable policy. The indicators show that poorer households have higher visitation rates under the FHS. Coverage of the eligible population is quite high: 88% of households received at least one visit from FHS professionals in the previous 12 months, resulting in a concentration index near zero.

Family health strategy and equity in prenatal care: a population based cross-sectional study in Minas Gerais, Brazil

BackgroundPrenatal care coverage is still not universal or adequately provided in many low and middle income countries. One of the main barriers regards the presence of socioeconomic inequalities in prenatal care utilization. In Brazil, prenatal care is supplied for the entire population at the community level as part of the Family Health Strategy (FHS), which is the main source of primary care provided by the public health system. Brazil has some of the greatest income inequalities in the world, and little research has been conducted to investigate prenatal care utilization of FHS across socioeconomic groups. This paper addresses this gap investigating the socioeconomic and regional differences in the utilization of prenatal care supplied by the FHS in the state of Minas Gerais, Brazil.MethodsData comes from a probabilistic household survey carried out in 2012 representative of the population living in urban areas in the state of Minas Gerais. The sample size comprises 1,420 women aged between 13 and 45 years old who had completed a pregnancy with a live born in the last five years prior to the survey. The outcome variables are received prenatal care, number of antenatal visits, late prenatal care, antenatal tests, tetanus immunization and low birthweight. A descriptive analysis and logistic models were estimated for the outcome variables.ResultsThe coverage of prenatal care is almost universal in catchment urban areas of FHT of Minas Gerais state including both antenatal visits and diagnostic procedures. Due to this high level of coverage, socioeconomic inequalities were not observed. FHS supplied care for around 80% of the women without private insurance and 90% for women belonging to lower socioeconomic classes. Women belonging to lower socioeconomic classes were at least five times more likely to receive antenatal visits and any of the antenatal tests by the FHS compared to those belonging to the highest classes. Moreover, FHS was effective in reducing low birthweight. Women who had prenatal care through FHS were 40% less likely to have a child with low birthweight.ConclusionThis paper presents strong evidence that FHS promotes equity in antenatal care in Minas Gerais, Brazil.

La equidad en la cobertura de la Estrategia de Salud Familiar en Minas Gerais, Brasil

A Estrategia Saude da Familia (ESF) tem papel relevante na prevencao e no acompanhamento das familias no Sistema Unico de Saude. O presente estudo tem como objetivo analisar a equidade na cobertura desses servicos ofertados na area urbana de Minas Gerais, Brasil. A pesquisa analisa diversos marcadores considerando quatro grupos-alvo: mulheres, gestantes, criancas e idosos, sendo representativa por macrorregiao de saude. Foram investigados em 2012, 6.797 domicilios, sendo entrevistados 5.820 mulheres, 1.758 criancas e 3.629 idosos. Para analisar a equidade, foram construidas taxas de cobertura da ESF por classe de riqueza e estimados indices e curvas de concentracao. Os resultados revelam que a ESF e uma politica equitativa. Os indicadores mostram que os domicilios mais pobres apresentam maiores taxas de visitacao da ESF. Considerando a populacao residente nas areas adscritas as equipes de saude, o nivel de cobertura e bastante elevado: 88% da populacao investigada receberam pelo menos uma visita dos profissionais da ESF nos ultimos 12 meses, o que resulta em indices de concentracao perto de zero.The Family Health Strategy (FHS) plays an important role in prevention and in monitoring families in the Brazilian Unified National Health System. This study aims to analyze equity in the coverage of these services in the urban areas of Minas Gerais State, Brazil. The research is unprecedented and analyzes several markers for four target groups: women, pregnant women, children, and the elderly. The study is representative of the various health macro-regions. In 2012, 6,797 households were surveyed, with 5,820 women, 1,758 children, and 3,629 elderly. To analyze equity, FHS coverage rates were calculated according to family income, and concentration indices and curves were estimated. The results show that the FHS is an equitable policy. The indicators show that poorer households have higher visitation rates under the FHS. Coverage of the eligible population is quite high: 88% of households received at least one visit from FHS professionals in the previous 12 months, resulting in a concentration index near zero.