Rosane Meire Munhak da Silva

História da saúde da criança: conquistas, políticas e perspectivas

Objetivou-se descrever e refletir sobre os aspectos relacionados a historia social e as politicas publicas de assistencia a saude da crianca no Brasil. Realizou-se breve contextualizacao historica sobre as transformacoes no ser crianca no Brasil e no mundo, apresentando-se as perspectivas referentes as politicas publicas de saude da crianca no âmbito nacional. Observou-se que a evolucao historica da participacao da crianca na sociedade encontra-se atrelada as mudancas nas politicas publicas de assistencia, traduzida em queda da mortalidade infantil, aliada a desafios como a reducao da morbimortalidade por agravos perinatais e causas evitaveis. Os avancos e conquistas na saude da crianca encontram-se em um movimento de mudanca paradigmatica para um modelo de construcao de redes e da integralidade do cuidado. Esse contexto aponta a necessidade de formacao de recursos humanos para esta area, tendo em vista a promocao e prevencao em saude, assim como uma melhor qualidade de vida dessa populacao.The aim of this study was describing and reflecting about the aspects related to the social history and public policies for the childrens health assistance in Brazil. A brief historical contextualization was realized concerning changes on the way the society views the child in Brazil and around the world, also perspectives considering public policies for the childrens health in the national context were presented. It was possible to identify that the historical evolution of the child participation in the society is linked to the changes in the assistance public policies, which were demonstrated in the child death decrease and associated to challenges, like the morbimortality reduction caused by perinatal injuries and avoidable causes. The advances and conquers in the childs health are evolved in a paradigmatic change movement into a model of a net formation and a comprehensiveness care. This context requires the human resources preparation for such area, based on the health promotion and prevention, as well as a better quality of life of the population.

Resolutividade na atenção à saúde da criança: percepção de pais e cuidadores

OBJECTIVE: Understand how the health problems of a child are solved in the perspective of parents and caregivers, based on the attributes of primary health care. METHODS: Qualitative study using a hermeneutic-dialectic approach involving 16 caregivers of children younger than one year old, assisted at an emergency unit. RESULTS: Lack of access, absence of bonding and coordination, and comprehensive care deprivation contribute to the lack of resolvability, leading to a search for alternatives to solve the health problems of children. CONCLUSION: As observed, primary health care services demonstrate no problem-solving capacity in childrens health problems, as the essential attributes for the effectiveness of such care were not present.

Acesso ao cuidado à saúde da criança em serviços de atenção primária

Llevo-se a cabo un estudio cualitativo basado en el marco metodologico de la hermeneutica dialectica, con el objetivo de identificar el atributo de acceso a la atencion primaria para resolver los problemas de salud de los ninos menores de un ano, a partir de los informes de los padres y cuidadores. Se involucro 16 cuidadores de ninos atendidos en las unidades de emergencia de Cascavel-PR, en 2010. Cuatro categorias tematicas fueron reconocidas: Asesoramiento de la familia en la busqueda de atencion de salud para el nino; Ausencia de acogimiento al primero contacto; Presencia de clasificacion de riesgo para el cuidado de la salud del nino; Barreras que impiden el acceso a la atencion sanitaria. Se concluyo que las familias tuvieron dificultades para lograr la solucion de los problemas de salud de los ninos, mediante la falta de acceso a los servicios de atencion primaria.It was conducted a qualitative study based on the methodological framework of dialectical hermeneutics, aiming to identify the attribute access from primary care to solve the health problems of children under one year old from the reports of parents and caregivers. Sixteen caregivers of children were involved, all of them seen in the emergency units of Cascavel-PR, in 2010. Four thematic categories were recognized: Family counselling in seeking health care for the child; Absence of reception on the first contact; Presence of risk classification to the child´s health attention; Barriers that block the access to health care. It was conclude that, families showed difficulties to reach the solution for their children´s health, because of the lack of access to primary care services.

A integralidade na assistência à saúde da criança na visão dos cuidadores

O artigo identifica o atributo integralidade e elementos do cuidado integral para resolucao de problemas de saude das criancas na percepcao de seus cuidadores. Pesquisa qualitativa, baseada na hermeneutica-dialetica, composta por 16 entrevistas e mapas falantes. Verificou-se: a assistencia a saude da crianca com um olhar focado na doenca, mas que o olhar para alem do biologico comeca a emergir; o cuidado centrado no exito tecnico em busca do sucesso pratico; a inexistencia de tecnologias leve-duras e duras para o cuidado. A parcialidade da integralidade levou a nao resolutividade dos problemas de saude infantil, demonstrando a necessidade de transformar o modo de pensar e fazer saude.

Práticas e percepções de educadores quanto ao aleitamento materno

Objective: To know education professionals’ breastfeeding-related practices and perceptions. Methods: Descriptive and exploratory study, with a qualitative approach. Data collection took place in 2015, with 19 education professionals working in nurseries of day-care centers in a bordering municipality of Southern Brazil. The Collective Subject Discourse technique was used in order to organize and tabulate the qualitative data. Results: The construction of the collective subject discourses led to the evidence that, in the teachers’ perception, breastfeeding is considered negative and there are no benefits in this practice for children enrolled in nursery I, mainly because the mothers could not manage to go to the daycare center. Thus, the place was regarded as an unsuitable location for the mother to breastfeed. The professional’s perception of breastfeeding renders it a hindrance to their professional practice and, therefore, the teaching, maintenance and promotion of breastfeeding doesn´t occur. Moreover, issues regarding the school infrastructure were mentioned as difficulties for the implementation of breastfeeding. Conclusion: The professionals consider that breastfeeding may represent a barrier to their professional performance; they report the existing difficulties for such practice and do not actually encourage it.

Rotina de exames na atenção ao pré-natal após a implantação do Programa Rede Mãe Paraense

Aim: to know the perceptions of health professionals and managers about the routine of examinations in prenatal care after the implantation of the Rede Mae Paranaense Program. Method: qualitative research, conducted in the first semester of 2015, through interviews with 19 professionals working in Primary Health Care services in municipalities of the ninth Regional Health Service of Parana, Brazil. Thematic analysis was used to analyze the results. Results: the nurse is primarily responsible for requesting the exams, the pregnant women have access to the laboratory exams, but the challenge remains in the release of the imaging exams. The difficulties were centered in the attention to brasiguaias, in the counter reference on the part of the high risk hospital, cost of the examinations, medical resistance in requesting some examinations, lack of resources and organization of the work. Final considerations: the program enabled improvements in the routine of exams. However, the difficulties that were highlighted may compromise attention to prenatal care.

PERCEPÇÃO, CONHECIMENTO E ATUAÇÃO DOS MÉDICOS NO PROGRAMA REDE MÃE PARANAENSE

This study aimed to understand how the health service’s doctors realize the “Programa Rede Mãe Paranaense” and how they act in the Program. A qualitative methodology was used from the perspective of Alfred Schutz’s social phenomenology. Seven interviews were performed between June and August 2014, by analysing 3 categories were identified: Knowledge about the “Programa Rede Mãe Paranaense”, Assistance in the Program and Expectations about the Program. The results show that doctors have knowledge about the program, but the participants said they didn’t have a special training to operate it. When referring to humanized care, it’s necessary to evaluate the actions considering the professional knowledge that each interviewed has. The information systems are not used and are not considered important during the assistance planning by the professionals, but they would like to know more about it. This study could help in improving the training and performance of professionals in maternal and child health. Descriptors: Government Programs; Public Policies; Health Promotion.

FATORES EPIDEMIOLÓGICOS CORRELACIONADOS AO RISCO PARA MORTE FETAL: REVISÃO INTEGRATIVA DA LITERATURA

Introduction: Despite the progress made in health care, it appears that fetal death remains a concern for public health services for a long time. It was neglected, and few investments were made to reduce it. Objective: Search scientific evidence demonstrating fetal, maternal, and social risk factors are related to fetal death. Material and Method: Integrative literature review of 16 papers from Scielo, Bireme and Pubmed, between 2005 and 2014, only in English and Portuguese and selected from the question: What fetal, maternal, and social risk factors are associated with fetal death? Titles and abstracts were read to select those to be read in their entirety, and for this, two researchers read the publications in order to see if the inclusions were consistent. Data collection occurred from September to December 2014. The hierarchical classification system known as level of evidence was used. Results: Publications cite risk factors for fetal death are not isolated events. The fetal risk factors described in 43.75% of the studies highlighted the low weight and congenital malformation. Maternal factors were cited in 81.25% of the articles, especially those related to maternal morbidities, such as hypertensive and hemorrhagic syndromes, syphilis, and gestational diabetes. In 43.75% of the publications, we could perceive the influence of low education, as well as black or brown skin; low socioeconomic conditions and inadequate prenatal care. Conclusion: Building studies on fetal health becomes relevant, since these have been little explored despite their incontestable importance for public health, and consider it as an indicator of quality of care prenatal.

Sentimentos e expectativas da gestante vivendo com HIV: um estudo fenomenológico

AIDS is a chronic disease increasing dramatically among the female population, especially amongst those women in their reproductive years, which can be seen in the increase of mother-to-child transmission of HIV cases. The objective of this research was to identify the feelings and expectations of such pregnant women about the disease and pregnancy from a phenomenological perspective. Five pregnant women living in Foz do Iguacu, Brazil and being monitored at the HIV/AIDS Specialized Service were selected as study subjects. Their accounts were collected through semi-structured interviews, which were recorded by digital media. Two Thematic Units were identified after the transcription and analysis of the discourses, namely, “The reality of prejudice, discrimination and stigmatization against pregnant women living with HIV” and “Emergent hope and expectations in a HIV pregnancy”. Despite prejudice, the pregnant women participating in the study had not lost hope neither in the treatment nor in the future. Several forms of expressing their problems were observed and the acceptance of being pregnant made them feel strong enough to face the situation.

History of the child's health: conquers, policies and perspectives

Objetivou-se descrever e refletir sobre os aspectos relacionados a historia social e as politicas publicas de assistencia a saude da crianca no Brasil. Realizou-se breve contextualizacao historica sobre as transformacoes no ser crianca no Brasil e no mundo, apresentando-se as perspectivas referentes as politicas publicas de saude da crianca no âmbito nacional. Observou-se que a evolucao historica da participacao da crianca na sociedade encontra-se atrelada as mudancas nas politicas publicas de assistencia, traduzida em queda da mortalidade infantil, aliada a desafios como a reducao da morbimortalidade por agravos perinatais e causas evitaveis. Os avancos e conquistas na saude da crianca encontram-se em um movimento de mudanca paradigmatica para um modelo de construcao de redes e da integralidade do cuidado. Esse contexto aponta a necessidade de formacao de recursos humanos para esta area, tendo em vista a promocao e prevencao em saude, assim como uma melhor qualidade de vida dessa populacao.The aim of this study was describing and reflecting about the aspects related to the social history and public policies for the childrens health assistance in Brazil. A brief historical contextualization was realized concerning changes on the way the society views the child in Brazil and around the world, also perspectives considering public policies for the childrens health in the national context were presented. It was possible to identify that the historical evolution of the child participation in the society is linked to the changes in the assistance public policies, which were demonstrated in the child death decrease and associated to challenges, like the morbimortality reduction caused by perinatal injuries and avoidable causes. The advances and conquers in the childs health are evolved in a paradigmatic change movement into a model of a net formation and a comprehensiveness care. This context requires the human resources preparation for such area, based on the health promotion and prevention, as well as a better quality of life of the population.