Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-01-14T19:30:13Z No. of bitstreams: 1 DandaraBatistaCorreia_DISSERT.pdf: 1690061 bytes, checksum: 0bd81c0f5064013970509b8d55601de9 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-01-15T22:17:59Z (GMT) No. of bitstreams: 1 DandaraBatistaCorreia_DISSERT.pdf: 1690061 bytes, checksum: 0bd81c0f5064013970509b8d55601de9 (MD5) / Made available in DSpace on 2016-01-15T22:17:59Z (GMT). No. of bitstreams: 1 DandaraBatistaCorreia_DISSERT.pdf: 1690061 bytes, checksum: 0bd81c0f5064013970509b8d55601de9 (MD5) Previous issue date: 2014-08-21 / O racismo tem participa??o ativa na defini??o das condi??es de sa?de, uma vez que reproduz no ?mbito da subjetividade e do consentimento, padr?es de integra??o ? ordem que restringem a popula??o negra do amplo acesso aos bens e servi?os socialmente produzidos. Por essa raz?o, as pessoas negras est?o expostas a situa??es diferenciadas de adoecimento, inclusive com maiores chances de exposi??o a certas doen?as e agravos com uma maior preval?ncia, como ? o caso da Doen?a Falciforme. Nesse sentido, o presente trabalho apresenta uma an?lise das express?es do racismo na sa?de da popula??o negra com Doen?a Falciforme, tendo como norte anal?tico o estudo das condi??es de sa?de e da qualidade da aten??o ? sa?de ofertada pela dire??o municipal do SUS, representada pela Secret?ria Municipal de Sa?de de Jo?o Pessoa/PB ? (SMSJPA). Trata-se de uma pesquisa social aplicada, fundada numa abordagem quantiqualitativa que envolveu a coleta de dados secund?rios, os quais foram sistematizados e analisados em dois momentos: 1) an?lise dos indicadores sociais referente ? popula??o negra no munic?pio a partir da base de dados do Censo Demogr?fico do IBGE; 2) estudo documental realizado no banco de dados do Programa Municipal da Doen?a Falciforme e An?lise dos relat?rios de gest?o da SMS-JPA referente a 2011, 2012 e 2013. Optou-se por uma vis?o cr?tica e dial?tica de leitura da realidade, com apoio nas categorias do racismo, racismo institucional e sa?de da popula??o negra compreendidas como uma unidade dial?tica. Os resultados revelam que a popula??o negra com Doen?a Falciforme est? inserida num contexto de vulnerabilidade social que repercute na sua situa??o de morbimortalidade. Aponta-se ainda que os problemas de sa?de das pessoas com Doen?a falciforme s?o preferencialmente resolvidos com base na aten??o b?sica a sa?de e por a??es focadas na preven??o de eventos agudos. Por essas caracter?sticas est?o focadas em a??es de baixa densidade tecnologia e de baixo custo que embora com maior alcance assistencial, provocam mudan?as de longo prazo, incapazes de alterar sua realidade de sa?de; No plano pol?tico institucional, essas respostas apresentam limites na aten??o ? sa?de, sobretudo no que se refere ao enfrentamento das desigualdades e promo??o da qualidade de vida, uma vez que as a??es exigem baixo poder de decis?o e consequentemente poucas altera??es nas estruturas dos sistemas de sa?de. Nesse esfor?o, espera-se contribuir com a produ??o de conhecimento que seja ?til para a??o pol?tico e cient?fico de grupos e movimentos interessados em ultrapassar as determina??es do racismo e construir uma nova ordem social fundamentada na emancipa??o de todas as formas de explora??o ?tnico/racial, sexual e de classes que signifique em melhorias na realidade de sa?de das pessoas com Doen?a Falciforme. / Racism has active participation in the definition of health conditions, since it reproduces within the subjectivity and consent, integration patterns to order that restrict the black population of broad access to goods and services produced socially. For this reason, black people are exposed to different risks of disease, including increased chances of exposure to certain diseases and disorders with a higher prevalence, such as the Sickle Cell Disease. In this sense, this paper presents an analysis of expressions of racism on the health of the black population with sickle cell disease, its analytical north the study of health conditions and quality of health care offered by the municipal administration of the SUS, represented by the Municipal Secretary of Jo?o Pessoa / PB (SMS-JPA) Health. It is a social applied research, based on a quantitative and qualitative approach that involved collecting secondary, which were organized and analyzed data in two stages: 1) analysis of social indicators regarding the black population in the municipality from the base Census data from IBGE; 2) documental study in database Municipal Program of Sickle Cell Disease and analysis of management reports related to SMSJPA 2011, 2012 and 2013 decided by a critical and dialectical reading of reality, with support in the categories of racism, institutional racism and health of the black population understood as a dialectical unity. The results reveal that the black population with sickle cell disease is embedded in a context of social vulnerability that affects his situation of mortality. It is pointed out also that the health problems of people with sickle cell disease are preferably solved based on primary care and health by focusing on prevention of acute events shares. For these characteristics are focused on technology stocks low density and low cost but with greater care range, causing long-term changes unable to change your health reality; The institutional political sphere, these responses have limits on attention to health, particularly with regard to addressing inequalities and promoting quality of life, since actions require low power of decision and consequently little change in the structures of health systems . In this effort, we hope to contribute to the production of knowledge that is useful for political and scientific action groups and movements interested in overcoming the determinations of racism and build a new social order based on emancipation from all forms of ethnic / racial exploitation, sexual and classes that actually means improvements in health of people with sickle cell disease.

Submitted by Verena Bastos (verena@uefs.br) on 2015-07-23T13:30:33Z No. of bitstreams: 1 Defesa_Luciane_16-09_14.pdf_2.pdf: 2365834 bytes, checksum: 5a75302c6266c54eadad17662f0f7dfb (MD5) / Made available in DSpace on 2015-07-23T13:30:33Z (GMT). No. of bitstreams: 1 Defesa_Luciane_16-09_14.pdf_2.pdf: 2365834 bytes, checksum: 5a75302c6266c54eadad17662f0f7dfb (MD5) Previous issue date: 2013-07-13 / Introduction: According to the World Health Organization, maternal morbidity is understood as the occurrence of complications during pregnancy, childbirth, or puerperium that if untreated can complicate and lead to death. Maternal mortality, in turn, is defined as the death of women of childbearing age (15 - 49 years) during pregnancy or within 42 days after delivery. Objective: To analyze maternal mortality in the state of Bahia in 2010, according to differences in race/sk in color. Methods: Descriptive and ecological study of multiple groups, of the maternal mortality in the 49 most populous cities in Bahia in 2010, according to race / skin color. Secondary data available in Health information systems (SIS), the mortality information system (MIS); Information System on Live Births (SINASC); Hospital information system (HIS) of the department of the SUS (SUS Date) and socioeconomic data from the Brazilian Institute of Geography and Statistics (IBGE) were used. To analyze the association between the independent and dependent variables, we used the logistic regression model of Poisson through of software STATA version 10 and R version 2.15.2. In spatial data was used ARCGIS application 10.0 Results: In 2010, Bahia, 209 444 hosp italizations of women of childbearing age were recorded. In the 49 municipalities with the highest population density 118,773 admissions occurred. Of these, 57,173 (48.1%) occurred in the black population, 6,938 (5.8%) in the white population; 54,551 (45.9%) without race / skin color information. The total number of maternal deaths in MIS aged 15- 49 years accounted for 154 deaths, with 85 of these deaths occurred in the 49 municipalities (55.2%). The Maternal Mortality Ratio (MMR) in Bahia was 72.5 / 100,000 live births (LB) as in the cities studied was 71.9 / 100,000 (LB). In the bivariate and multivariate analyzes of association was observed that the number of maternal deaths was positively associated with the proportion of black population, since, as the proportion of blacks increased 5%, the risk of maternal death increased to 25.2 % (p <0.0278) and 26.6% (p <0.0366), respectively. In the bivariate analysis of HDI and Gini index also associated, but were not statistically significant. The multivariate analysis showed that there was increased risk of death even when adjusted for variable water rate (WR), and this result was statistically significant. Conclusion: The analyzed data revealed higher incidence and prevalence of maternal mortality in the black population. Underreporting related to completing the race / skin color variable records hinders a more precise analysis of morbidity and mortality and represents a gap due to the effectiveness of health interventions for vulnerable groups of women. The red uction of maternal morbidity and mortality should be a universal and emergency commitment. Investments in humanization and universalization of quality maternal health care constitute a significant affirmative action against exclusion and social injustice. / Introdu??o : De acordo com a organiza??o Mundial de Sa?de, a morbidade materna ? compreendida como a ocorr?ncia de complica??o durante a gesta??o, parto, ou puerp?rio que, se n?o tratadas podem complicar e levar ? morte. A mortalidade materna, por sua vez, ? definida como a morte de mulheres em idade f?rtil (15 - 49 anos) durante a gesta??o ou nos 42 dias ap?s o parto. Objetivo: analisar a morbimortalidade materna no estado da Bahia em 2010, segundo diferenciais de ra?a/cor da pele. M?todos: Estudo descritivo e ecol?gico, de m?ltiplos grupos, da morbimortalidade materna nos 49 munic?pios mais populosos da Bahia, em 2010, segundo a ra?a/cor da pele. Foram utilizados dados secund?rios disponibilizados nos Sistemas de informa??o em Sa?de (SIS), Sistema de informa??o sobre mortalidade (SIM); Sistema de informa??o sobre Nascidos Vivos (SINASC); Sistema de informa??o hospitalar (SIH) do departamento de inform?tica do SUS (Data SUS) e dados socioecon?micos do Instituto Brasileiro de Geografia e Estat?stica (IBGE). Para an?lise da associa??o entre as vari?veis independentes e dependentes utilizou- se o modelo de regress?o log?stica de Poisson atrav?s do software STATA vers?o 10 e R vers?o 2.15.2. Na espacializa??o dos dados foi usado aplicativo ARCGIS 10.0 Resultados : Em 2010, na Bahia, foram registrados 209.444 internamentos de mulheres em idade f?rtil. Nos 49 munic?pios com maior densidade populacional ocorreram 118.773 internamentos. Destes, 57.173 (48,1%) ocorreram na popula??o negra, 6.938 (5,8%) na popula??o branca; 54.551(45,9%) sem informa??o da ra?a/cor da pele. O total de ?bitos maternos registrados no SIM na faixa et?ria de 15 - 49 anos correspondeu a 154 ?bitos, sendo que 85 destes ?bitos ocorreram nos 49 munic?pios (55,2%). A Raz?o de Mortalidade Materna (RMM) na Bahia foi 72,5/100.000 Nascidos vivos (NV) enquanto nos munic?pios estudados foi 71,9/100.000(NV). Nas an?lises de associa??o bivariada e multivariada observou- se que o n?mero de mortes maternas associou- se positivamente com propor??o de popula??o negra, j? que, ? medida que a propor??o de popula??o negra aumentou 5%, o risco de morte materna aumentou para a 25.2% (p < 0.0278) e 26.6%(p<0.0366) respectivamente. Na an?lise bivariada ?ndice de Gini e IDH tamb?m se associaram, mas n?o foram estatisticamente significantes. Na an?lise multivariada foi observado que houve aumento no risco de morte mesmo quando ajustado pela vari?vel taxa de ?gua (TXAG), sendo esse resultado es tatisticamente significante. Conclus?o : Os dados analisados revelaram maior incid?ncia e preval?ncia de morbimortalidade materna na popula??o negra. A subnotifica??o de registros relacionados ao preenchimento da vari?vel ra?a/cor da pele dificulta uma an?lise mais precisa da morbimortalidade e representa uma lacuna face ? efetividade das a??es em sa?de para grupos de mulheres mais vulner?veis. A redu??o da morbidade e mortalidade materna deve ser um compromisso universal e emergencial. Investimentos em humaniza??o e universaliza??o da qualidade da assist?ncia ? sa?de materna constituem uma significativa a??o afirmativa contra a exclus?o e a injusti?a social.