Made available in DSpace on 2014-12-17T15:31:00Z (GMT). No. of bitstreams: 1 RicardoDC.pdf: 826837 bytes, checksum: a7ad11918ea2c5f5b732ad0bfee98c9e (MD5) Previous issue date: 2007-02-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Due to the fact of oral health sector reestructuration within Brazilian public health politics, this work had the object of evaluating, under users point of view, the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect. To achieve this, questionnaires were given to users in their homes, considering the censitary sector. Nine sectors of the urban zone were evaluated, selected by chance, and one from the rural zone, selected by convenience. The sample was composed by 194 users, calculated considering the estimated prevalence of event represented by the indicator I ve never been to the dentist + I ve been to the dentist more than three years ago from the Projeto SB Brasil Report . To complement the results, interviews were made with others actors involved in the process of oral health care: professionals (dentists) and manager (Health Municipal Secretary). From the data obtained it was possible to identify that 12,9% of the population had never visited the dentist, and that the search for the service was not influenced by the users individual and socioeconomics characteristics, excepting the gender. It was verified that 36,1% of the users went to the dentist in less than one year, with the youngests (p<0,05) being among those who went to the dentist more frequently. 63,3% of the interviewed related that they found some kind of difficulty when they search for dentistry services, with the difficulties for schedule, the queues and the long wait among the most cited. It was identified that 43,2% of the users wait three weeks or more for the appointment. It is still pointed out that 71,4% of the interviewed find difficulties to get urgency appointment, the long wait to be attended by the dentist was the most found. 92,9% and 94,1% of the interviewed had never been headed to especialized appointments and complementary exams, respectively. Due to the data founded, it was possible to verify that the accessibility to oral health services in Santa Cruz (RN) is damaged by factors related to the organization of public polices developed, mainly in relation to the working process / Diante do fato de reestrutura??o do setor sa?de bucal dentro das pol?ticas p?blicas de sa?de brasileiras, este trabalho se prop?s avaliar, sob o ponto de vista dos usu?rios, a acessibilidade aos servi?os de sa?de bucal no munic?pio de Santa Cruz (RN), enfocando o aspecto organizacional. Para tanto, question?rios foram dirigidos aos usu?rios em seus domic?lios, considerando o setor censit?rio. Foram avaliados 9 setores da zona urbana, escolhidos atrav?s de sorteio, e 1 da zona rural, selecionado por conveni?ncia. A amostra foi composta por 194 usu?rios, calculada considerando a preval?ncia estimada do evento representada pelo indicador nunca foi ao dentista + foi ao dentista h? mais de tr?s anos do Relat?rio do Projeto SB Brasil. Para complementa??o dos resultados, ainda foram realizadas entrevistas com outros atores envolvidos no processo de produ??o de sa?de bucal: profissionais (Cirurgi?es-Dentistas) e Gestor (Secret?rio Municipal de Sa?de). A partir dos dados obtidos foi poss?vel identificar que 12,9% da popula??o nunca visitaram o dentista, e que a procura pelo servi?o n?o foi influenciada pelas caracter?sticas individuais e socioecon?micas dos usu?rios, com exce??o do g?nero. Verificou-se que 36,1% dos usu?rios buscaram o dentista em menos de ano, estando os mais jovens (p<0,05) entre aqueles que buscam o dentista com mais freq??ncia. 63,3% dos entrevistados relataram encontrar algum tipo de dificuldade quando da busca pelo atendimento odontol?gico, estando as dificuldades para agendamento, a exist?ncia de filas e longa espera entre os mais citados. Foi identificado que 43,2% dos usu?rios esperam 3 semanas ou mais pelo atendimento. Destaca-se ainda que 71,4% dos entrevistados encontram dificuldades para conseguir atendimento de urg?ncia, sendo a longa espera pela consulta a mais citada. 92,9% e 94,1% dos entrevistos nunca foram encaminhados para realiza??o de consultas mais especializas e exames complementares, respectivamente, evidenciando que os usu?rios n?o est?o recebendo atendimentos integrais. Diante dos dados encontrados p?de-se verificar que a acessibilidade aos servi?os de sa?de bucal do munic?pio de Santa Cruz (RN) encontra-se prejudicada por fatores relacionados ? organiza??o das pol?ticas p?blicas desenvolvidas, principalmente no que se refere ao processo de trabalho

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-22T19:29:09Z No. of bitstreams: 1 MarcelaFernandesDeAraujoBatistaDeMorais_DISSERT.pdf: 1437009 bytes, checksum: 82683a52ce54fddf852e05ff414bc844 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-07T20:05:55Z (GMT) No. of bitstreams: 1 MarcelaFernandesDeAraujoBatistaDeMorais_DISSERT.pdf: 1437009 bytes, checksum: 82683a52ce54fddf852e05ff414bc844 (MD5) / Made available in DSpace on 2017-03-07T20:05:55Z (GMT). No. of bitstreams: 1 MarcelaFernandesDeAraujoBatistaDeMorais_DISSERT.pdf: 1437009 bytes, checksum: 82683a52ce54fddf852e05ff414bc844 (MD5) Previous issue date: 2016-08-11 / No processo de constru??o do Sistema ?nico de Sa?de se fortalece e se evidencia a import?ncia da Aten??o Prim?ria ? Sa?de. Dentro desta h? a??es priorit?rias, dentre as quais se encontra o acompanhamento pr?-natal e puerperal. O presente estudo teve como objetivo avaliar a aten??o ? sa?de da mulher no ciclo grav?dico-puerperal na regi?o Nordeste do Brasil atrav?s dos dados do Programa de Melhoria e Acesso da Qualidade da Aten??o B?sica. Trata-se de um estudo avaliativo, com abordagem quantitativa, no qual foram utilizados dados secund?rios obtidos atrav?s do banco da avalia??o externa dos dois ciclos realizados pelo programa. Participaram respondendo o instrumento, 5146 profissionais de sa?de em cada ciclo de avalia??o, e em rela??o aos usu?rios, responderam as quest?es voltadas ao pr?-natal, 1732 mulheres no primeiro ciclo, e 2004 mulheres no segundo ciclo. Para as vari?veis correspondentes ao puerp?rio, participaram 1743 mulheres no primeiro ciclo, e 1952 mulheres no segundo ciclo. Os resultados foram apresentados e discutidos em dimens?es voltadas a estrutura, processo de trabalho no pr?-natal e processo de trabalho no puerp?rio. No tocante ? infraestrutura, observou-se melhoria em quase totalidade das suas vari?veis, tendo apenas a disponibilidade de ?cido f?lico regredido de um ciclo para outro. Apesar desses avan?os, algumas vari?veis, tais como: baixa disponibilidade de testes r?pidos de HIV, s?filis e gravidez, merecem destaque. Em rela??o ao processo de trabalho no pr?-natal, os dados mostram grande defici?ncia em rela??o ? educa??o em sa?de, destaca-se tamb?m a regress?o percentual na maioria das vari?veis voltadas ? orienta??o das mulheres. No processo de trabalho no puerp?rio foi identificado que um grande n?mero de mulheres n?o realizou consulta puerperal. Para tanto, para as que realizaram, foi identificado um avan?o importante no tocante a essa realiza??o no prazo de at? 10 dias. Tamb?m foi observada regress?o quando analisada ? visita do Agente Comunit?rio de Sa?de na primeira semana p?s-parto. No geral, quando comparados o primeiro com o segundo ciclo do programa, percebem-se avan?os, embora ainda haja desafios a serem superados. / In the process of construction of the Single Health System (SUS), it is stronger and more evident the importance of National Primary Care (NPC). There are some high-priority actions, among others, the prenatal and puerperal assistance.The present study aimed to evaluate women?s health care in the pregnant and puerperal cycle in the Northeast of Brazil through the data of the NPCAQIP.It is an evaluation study, with quantitative approach. The data used was obtained through the external evaluation bank of the NPCAQIP. The number of participants who took part in the study was 5146 health care professionals on each cycle of evaluation, and concerning the clients, 1732 women on the first cycle took part in the study answering questions related to prenatal and 2004 women on the second cycle. For the variable concerning the puerperium, 1743 women took part on the first cycle and 1952 women took part on the second one.The results were presented and discussed in different dimensions related to structure, process of work in the prenatal and process of work in the puerperium. Concerning the infrastructure, it could be noticed an almost total improvement of its variables, just with regression of the availability of folic acid from one cycle to another. Despite this progress, some variables deserve attention, such as: low availability of HIV, syphilis and pregnancy rapid tests. In relation to the process of work in the prenatal, data showed great deficiency related to health education, it is also highlighted the percentage regression of women orientation on most variables. In the process of work in the puerperium it was identified that a considerable amount of women did not have puerperal consultation. Therefore, for the ones who had, it was identified a progress related to the importance of having this consultation within 10 days. It was also observed the regression of the visit of the Community Health Agent on the first week post-partum. In general, when we compare the first and second cycles of the program, it can be noticed advances, however there are still some challenges to be overcome.

Made available in DSpace on 2014-12-17T15:30:53Z (GMT). No. of bitstreams: 1 GeorgiaCAS.pdf: 1172018 bytes, checksum: ddbd3f0e4914969b01e2de84e34c11fb (MD5) Previous issue date: 2009-04-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems / Os Centros de Especialidades Odontol?gicas (CEOs) foram criados para assegurar atendimentos odontol?gicos especializados ? popula??o brasileira, diante das necessidades de sa?de acumuladas h? bastante tempo. Devem funcionar como unidades de refer?ncia para as Equipes de Sa?de Bucal da Aten??o B?sica, com procedimentos cl?nicos odontol?gicos complementares aos realizados neste n?vel de aten??o. Este estudo objetiva avaliar o desempenho dos CEOs da Regi?o de Sa?de da Grande Natal como estrat?gia de consolida??o da Aten??o Secund?ria em sa?de bucal atrav?s dos usu?rios, cirurgi?es-dentistas e diretores. Para isto busca-se identificar fatores relacionados ao acesso, acolhimento e satisfa??o com o servi?o, as a??es desenvolvidas nestes centros, integra??o entre os CEOs e as Unidades B?sicas de Sa?de (UBS), considerando a rela??o de refer?ncia e contra-refer?ncia. Os dados foram coletados atrav?s de entrevista semi-estruturada, realizadas em quatro CEOs, entre 253 usu?rios, 31 dentistas e 4 diretores, e submetidos ? an?lise estat?stica descritiva e ? an?lise de conte?do informatizada atrav?s do software ALCESTE 4.5. Os resultados mostraram que as especialidades de pr?tese, endodontia e cirurgia foram as mais procuradas, por 38,2%, 23,7% e 21,7% dos entrevistados, respectivamente. Percebeu-se que entre os usu?rios na faixa et?ria de 18 a 30 anos a maior procura ? para a especialidade de endodontia (44,4%) e os acima de 50 anos, para pr?tese (76,4%). Observa-se uma fragilidade no sistema de refer?ncia e contra-refer?ncia entre a UBS e o CEO, na medida em que parte dos usu?rios v?o diretamente aos centros sem passar antes pela Aten??o B?sica e a maioria n?o deseja retornar ao dentista da Unidade de Sa?de. A satisfa??o com o atendimento foi relatada por 90,9% dos usu?rios, pois conseguiram resolver os problemas que precisavam e foram bem acolhidos pela equipe. Por?m, a demora no atendimento foi o principal fator para a n?o satisfa??o. Para a maioria dos dentistas, alguns usu?rios poderiam resolver seus problemas completamente na Aten??o B?sica, o que revela a exist?ncia de encaminhamentos desnecess?rios aos CEOs, entretanto consideram a exist?ncia de fatores limitantes nas UBS que comprometem o atendimento. Grande parte dos dentistas revelou que a maioria dos usu?rios n?o chega aos CEOs com o tratamento odontol?gico b?sico realizado, e alguns n?o contra-referenciam os usu?rios. Pode-se concluir que os CEOs estudados est?o sendo resolutivos para aqueles que os acessaram, oferecendo atendimentos necess?rios ? popula??o que, se n?o contasse com esse servi?o, encontraria entraves ? resolu??o dos problemas, indo buscar atendimento no servi?o particular, em outro setor p?blico, ou at? desistindo do tratamento. Contudo, percebe-se a necessidade de capacita??o dos profissionais para que compreendam a import?ncia da refer?ncia e da contra-refer?ncia e que possam melhor atender e orientar os usu?rios. Tamb?m ? preciso que os munic?pios ofere?am melhores condi??es ?s UBS e aos CEOs, para que possam atuar conjuntamente, com a??es complementares de sa?de bucal, atendendo a popula??o de maneira integral e resolutiva