Renata Palópoli Pícoli

Atendimentos a brasileiros residentes na fronteira Brasil-Paraguai pelo Sistema Único de Saúde

OBJETIVO: Identificar e analisar as caracteristicas dos atendimentos realizados no Sistema Unico de Saude (SUS) a brasileiros residentes no exterior em Ponta Pora, Coronel Sapucaia, Paranhos e Sete Quedas, municipios fronteiricos de Mato Grosso do Sul com o Paraguai. METODOS: Os dados foram colhidos durante 30 dias atraves de um formulario para cada atendimento efetuado. Foram estudados todos os servicos de saude do SUS disponiveis nos quatro municipios (14 unidades basicas de saude da familia, quatro unidades basicas de saude, cinco hospitais e quatro laboratorios). Tambem foram realizadas entrevistas semiestruturadas com informantes-chave (secretarios de saude, gerentes das unidades de saude e representantes do conselho municipal de saude). RESULTADOS: Constatou-se que a maior demanda de atendimentos a brasileiros nao residentes no Pais foi nos servicos de atencao basica: 11,9% nas unidades basicas de saude da familia de Coronel Sapucaia, 1,1% nas de Sete Quedas, 3,5% em Paranhos e 3,5% em Ponta Pora. Nas unidades basicas de saude, o percentual foi de 21,1, 43,8, 14,7 e 2,3%, respectivamente. As entrevistas confirmaram a percepcao de que existe um numero importante de brasileiros que moram no exterior recebendo atencao pelo SUS nessas cidades. CONCLUSOES: Uma proporcao consideravel de brasileiros nao residentes no Pais busca atendimento pelo SUS nos municipios brasileiros. Entretanto, essa demanda nao e considerada no planejamento dos servicos e pode causar impacto na qualidade da atencao prestada.

Processo regulatório da Estratégia Saúde da Família para a assistência especializada

It was aimed to know the regulatory process of the Family Health Strategy for specialized care in Campo Grande, Mato Grosso do Sul. Descriptive study, with 53 physicians, whose data collection used a structured and self-administered questionnaire. The professionals (50.9%) considered that the regulation contributes to the coordination of the care, that the return of the referrals is due to the lack of clarity of the test results (57.1%) and that the main measure to improve the access to the specialized care would be the increase of positions. A greater communication among the professionals involved in the regulatory process should be encouraged, in order to provide the full exercise of their functions.

Maternal mortality according to race/skin color in Mato Grosso do Sul, Brazil, from 2010 to 2015

Objectives: to investigate the epidemiological profile, by race/skin color, of maternal deaths in the state of Mato Grosso do Sul, Brazil. Methods: the present epidemiological study of maternal death distribution by race/skin color was based on data extracted from Brazilian mortality and livebirth information systems from 2010 to 2015. The maternal mortality ratio and the specific maternal mortality ratio were calculated and analyzed according to obstetric variables. Results: the death risk for black (RR = 4.3, CI95%= 2.08-8.71) and indigenous women (RR = 3.7, CI95% 2.2-6.23) was approximately fourfold in comparison to the risk for white women. For direct causes of death, the state of Mato Grosso do Sul showed higher levels, 74.1%, as well as for most races/skin colors in the first triennium. The specific maternal mortality ratio was higher among black and indigenous women aged30 to 39 years old (416.7 and 651.8, respectively) per 100,000 live births (p<0.05). Conclusions: higher maternal mortality ratio for indigenous and black women and the predominance of deaths related to direct obstetric causes among race/skin color categories reflect inadequate health care during pregnancy and puerperium.

Doenças e práticas terapêuticas entre os Teréna de Mato Grosso do Sul

This article aims to describe the views of health and disease held by the Terena people of the Buriti Indigenous Land, in the state of Mato Grosso do Sul, Brazil, devoting closer attention to the iden tification and diagnostic interpretation of chronic disease and related therapeutic practices. Con ducted from March to August 2010, this qualitative study employed semi-structured interviews with 24 Terena members and was complemented with field notes (participant observation). The understanding of health and disease held by the Terena are integral to daily life issues such as diminishing land avail ability, climate change, influences of urban life, and rule-breaking. Observations regarding therapeutic processes revealed an interest in counseling, as well as in family and religious care, concurrently with the biomedical care obtained at the local health cen ter - resources that are seen as complementary. The interpretive schemes reported by the participants for the causality of hypertension bear relation with living conditions, environmental contamination, dietary changes, spell-casting, and disobedience to older adults. Understanding disease and seeking cure are experienced by the Terena as processes stemming from local knowledge, involvement of various participants, and available resources and technologies, each of them part of a dynamic cul tural and social context.