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Utilization of immunization services among mothers of under 1 year old children in sub-district Turbat, district Kech, Balochistan, Pakistan /Farooq, Ghulam, Boonyong Keiwkarnka, January 1999 (has links) (PDF)
Thesis (M.P.H.M.)--Mahidol University, 1999.
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Estudo dos procedimentos quanto à conservaÃÃo das vacinas do Programa Nacional de ImunizaÃÃo em Teresina-PI. / Study Issues Relating to the Conservation of Vaccines of the National Immunization Program in Teresina-PI.Samira RÃgo Martins de Deus 11 January 2011 (has links)
nÃo hà / A vacinaÃÃo representa um dos mais belos e bem sucedidos avanÃos da medicina. à importante destacar que os princÃpios e as normas de conservaÃÃo das vacinas sÃo fatores determinantes na eficÃcia das mesmas, sem os quais as vacinas nÃo teriam nenhum efeito. Este trabalho teve como objetivo avaliar o processo de conservaÃÃo dos imunobiolÃgicos do Programa Nacional de ImunizaÃÃo (PNI) nas salas de vacina da zona urbana de Teresina-PI. Tratou-se de um estudo epidemiolÃgico realizado em 53 salas de vacina, distribuÃdas por Regional de SaÃde da seguinte forma: 20 na zona centro-norte, 19 na zona sul e 14 na zona leste, no perÃodo de setembro de 2008 a fevereiro de 2009. Os resultados mostraram que nas salas de vacina da zona Centro-Norte apenas 60% possuÃam tamanho adequado e bancada de inox; somente 35% dispunham de macas; 30% nÃo estavam distantes de calor e incidÃncia de luz solar; 95% nÃo funcionavam em horÃrio integral e quanto à capacitaÃÃo dos funcionÃrios, 10% destes nÃo possuÃam capacitaÃÃo em sala de vacina, 40% em BCG, 95% em rede de frio e 80% em efeitos adversos. Nas salas de vacina da zona Sul somente 26,3% possuÃa bancada de inox; 36,8% tinham tamanho adequado; 32% dispunham de macas, 21,1% nÃo estavam distantes de calor e incidÃncia de luz solar; a lavagem do refrigerador nÃo era realizada conforme preconizado pelo PNI em 26,3% das salas; em 31,6% nÃo era feito a organizaÃÃo adequada de imunos na caixa tÃrmica; 85,9% nÃo funcionavam em horÃrio integral e quanto a capacitaÃÃo dos funcionÃrios, 21,1% nÃo possuÃam capacitaÃÃo em sala de vacina, 57,9% em BCG, 100% em rede de frio e 89,5% em efeitos adversos. Nas salas de vacina da zona Leste foi visto que todas possuÃam tamanho adequado; 50% tinham bancada de inox; 43% dispunham de macas; 71,4% nÃo monitoravam a temperatura das caixas tÃrmicas; 64% nÃo funcionavam em horÃrio integral e quanto a capacitaÃÃo dos funcionÃrios, todos tinham mais de 2 anos que haviam sido capacitados em sala de vacina, 36% nÃo possuÃam capacitaÃÃo em BCG, 93% em rede de frio e em efeitos adversos. Pode-se concluir com este estudo que para que as atividades de vacinaÃÃo atinjam resultados coerentes com o desejado, faz-se necessÃrio alÃm das altas coberturas, uma capacitaÃÃo dos profissionais que atuam em sala de vacina, como tambÃm, o monitoramento dos processos que envolvem a manipulaÃÃo dessas substÃncias. / Vaccination represents one of the most beautiful and successful advances in medicine. Importantly, the principles and standards for vaccine storage are decisive factors in the effectiveness of the same, without which the vaccine would have no effect. This study aimed to evaluate the conservation of biological process of the National Immunization Program (NIP) in rooms of vaccine from the urban area of Teresina-PI. This was an epidemiological study conducted in 53 rooms of vaccine distributed by the Regional Health as follows: 20 in the central-north zone, 19 in the south zona and 14 in the east zone, considering the period between September 2008 and February 2009 . The results showed that in the halls of vaccine from noth central zone, only 60% had adequate size and stainless steel bench, only 35% had gurneys, 30% were not far from heat and sunlight, 95% did not work on schedule full and on the training employees, 10% of these had no training in vaccine, BCG 40%, 95% in the cold chain and 80% in adverse effects. In the halls of vaccine from the South zone only 26.3% had a stainless steel countertop, 36.8% had adequate size, 32% had gurneys, 21.1% were not far from heat and sunlight, washing cooler was not performed as recommended by the NIP in 26.3% of the rooms, at 31.6% was not done the proper organization of immunosuppressive in the insulated box, 85.9% were not working full time and the training of officials, 21, 1% had no training in vaccine, 57.9% in BCG, 100% in the cold chain and 89.5% in adverse effects. In the halls of vaccine from the East zone was seen that all had adequate size, 50% were stainless steel countertop, 43% had gurneys, 71.4% were not monitored the temperature of the coolers and 64% did not work full time and about training of officials, all had more than 2 years who had been trained in vaccine, 36% had no training in BCG, 93% in the cold chain and adverse effects. This study concludes that for vaccination activities to achieve results consistent with the desired, it is necessary beyond vaccination campaigns, a capacitation (empowering training) of health workers in vaccine, but also the monitoring of processes that involve handling these substances.
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Basta aplicar uma injeção? Saúde, doença e desenvolvimento: o Programa de Erradicação da Bouba no Brasil(1956-1961) / Only an injection is enough? health, disease and development: the Programa de Erradicação da Bouba in Brasil(1956-1961)Muniz, Érico Silva Alves January 2009 (has links)
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Previous issue date: 2009 / A dissertação tem por objetivo apresentar as medidas para controle e erradicação da bouba ocorridas no Brasil no período entre 1956 e 1961. O Programa de Erradicação da bouba -com seu método de injeções únicas de penicilina - percorreu em campanha itinerante os estados do nordeste e de Minas Gerais em seus primeiros cinco anos. Durante as atividades da campanha nas principais áreas endêmicas do país emergiram também outras questões relacionadas à alimentação, pobreza e condições de vida das populações do interior. O trabalho ressalta como uma campanha para a erradicação de uma endemia rural estruturada em torno de uma bala mágica, a penicilina injetável, se defrontou com os quadros de fome e desnutrição no interior do país, problemas que, a princípio, estavam fora de suas atribuições.
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Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian childrenMezones Holguín, Edward, Bolaños Díaz, Rafael, Fiestas, Víctor, Sanabria, César, Gutiérrez Aguado, Alfonso, Fiestas, Fabián, Suárez, Víctor J., Rodríguez Morales, Alfonso J., Hernández, Adrian V. 08 January 2015 (has links)
emezones@gmail.com / Introduction: Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 yearsold. Methodology: A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. Results: The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, andUSD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). Conclusions: PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule. / This study was funded by Instituto Nacional de Salud,
Lima, Peru / Revisión pór pares
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Hur tänkte ni? - Anledningar föräldrar har att inte vaccinera sina barn : en deskriptiv litteraturstudieSvedberg, Sarah, Thorén, Julia January 2017 (has links)
Bakgrund: Antalet ovaccinerade barn ökar och ca 134 200 människor dör varje år i en sjukdom som kan förhindras med hjälp av de välutvecklade vaccinationsprogrammen. Majoriteten av dödsfall är barn under fem år. UNICEF och WHO har som målsättning att alla barn i världen ska ha rätt till ett fullständigt skydd mot de sex vanligaste barnsjukdomarna. Syfte: Syftet med denna litteraturstudie var att beskriva varför vissa föräldrar väljer att inte vaccinera sina barn samt att granska vilka datainsamlingsmetoder de inkluderade artiklarna har använt sig av. Metod: Den föreliggande litteraturstudien var av deskriptiv design där 12 stycken vetenskapliga artiklar granskats. De inkluderade artiklarna hade kvantitativ, kvalitativ eller mixad ansats. Huvudresultat: Föräldrar hade olika anledningar till varför de valde att avstå från att vaccinera sitt barn. Faktorer som visade sig påverka föräldrar i deras val att vaccinera sitt barn eller inte var bristande information, att vaccin ansågs vara onaturligt och farligt för barnets immunförsvar, att föräldrarna ansåg att de kunde skydda barnet från att bli smittad av sjukdomar, att biverkningar skulle uppstå samt påverkan från internet, familj och vänner. Studierna hade olika tillvägagångssätt för datainsamling. De var antingen enkäter, intervjuer eller insamlad data från journalsystem. Slutsats: Det är viktigt att sjukvården är medveten om de olika faktorer som påverkar föräldrar i deras val rådande vaccinationer för att kunna bidra med en individanpassad information utefter föräldrarnas kunskap och ställningstagande om vaccinationer. / Background: The number of unvaccinated children is increasing and approximately 134 200 people die each year from a disease that can be prevented with the help of the developed vaccination programs. The majority of the deaths are children under five. UNICEF and WHO is committed to give every child in the world the right to full protection against the six most common childhood illnesses. Aim: The aim of this study was to describe why some parents choose not to vaccinate their children. The aim was also to review what data collection methods that was used in the included articles. Method: The present literary study was of a descriptive design where 12 pieces of scientific papers had been reviewed. The including articles had either a quantitative, a qualitative or mixed approach. Main result: Parents had different reasons why they chose not to vaccinate their children. Factors found to influence parents in their choice to vaccinate their children or not was a lack of information, the vaccine was considered unnatural and dangerous for the child's immune system, the parents felt that they could protect the baby from being infected by the disease, the side effects that could occur and the impact of the internet, family and friends. The studies had different approaches to data collection. They were either surveys, interviews or data collected from medical journals. Conclusion: It is important that health care personnel is aware of the various factors that influence parents vaccine choices to provide a personalized information by the parents knowledge and position on vaccinations.
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Incompletude do calendário vacinal infantil e fatores associado: análise hierarquizada em uma coorte de nascimento - BRISA, no Nordeste do Brasil / Incompleteness of the childhood immunization schedule and associated factors: a hierarchical analysis in a birth cohort - BRISA, in Northeast BrazilSilva, Francelena de Sousa 21 January 2016 (has links)
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Previous issue date: 2016-01-21 / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) / Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (FAPEMA) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / The actions of child immunization are important to reducing child mortality, one of the Millennium development goals. For this, it is necessary that the vaccine coverage comply with the Ministry of Health recommendations. The data produced in the vaccination services are less reliable and still occur differences related to socio-economic factors associated to child vaccination. The study aimed to evaluate the factors associated to the incompleteness of basic vaccination schedule (BVS) and vaccination schedule for new vaccines (VSNV) (meningococcal C and pneumococcal 10) in children from 13 to 35 months old, from a birth cohort, in São Luis, Maranhão, Brasil. The sampling was probabilistic at birth, compound 3.076 children born in the year of 2010. The information regarding to vaccination was obtained from the vaccine card. The vaccines considered to BS were BCG, hepatitis B, polio, tetravalent, rotavirus, yellow fever and MMR, and for VSNV, were meningococcal and pneumococcal. An hierarchical analysis was held using Poisson regression with robust variance adjustment. Prevalence ratios (PR) were estimated and respective confidence intervals 95% (CI95%). The BS was incomplete in 33.2 % of children and VSNV at 51.1%. Largest incompleteness ratios of BS as VSNV were found in children whose mothers were teens (BS: PR=1.26 and CI 95% 1.10-1.45; NV: PR=1.15 and CI 95% 1.05-1.27), resided with other children (BS: PR=1,32 and CI95% 1,17-1,49; NV: PR=1,29 and CI95% 1,19-1,40 with one: BS: RP=1,55 and CI95% 1,34-1,80; NV: PR=1,3 and CI95%1,24-1,52 with two or three; BS: PR=1.81 and CI95% 1.41-2.33; NV: PR=1.36 and CI95% 1.11-1.67 with more than three), had smoking habit (BS: PR=1.52 and CI95% 1.28-1.82: NV: PR=1.22 and CI95% 1.07-1.40), don’t planned pregnancy (BS: PR=1.18 and CI95% 1.05-1.31; NV: PR=1.09 and CI95% 1.00-1.10), got pregnant just after the birth of the child under study (BS: PR=1.22 and CI95% 1.04-1.43; NV: PR=1.16 and CI95% 1.03-1.29), made a few prenatal appointment (BS: PR=1.25 and CI95% 1.11-1.40; NV: PR=1.15 and CI95% 1.06-1.25) and started it late (BS: PR=1.40 and CI95% 1.06-1.86; NV: PR=1.27 and CI95% 1.07-1.52). Sociodemographic and behavioral vulnerability indicators and low prenatal service using, were associated to incompleteness of childhood vaccination. It is suggested to consider these vulnerabilities at vaccination strategies, in order to contribute to the achievement of high vaccine coverage both from basic schedule as new vaccines introduced in childhood vaccination, and with that, to enable the child population greater protection against imunopreventable diseases. In addition to provide that pregnant women perform more prenatal appointment and do it so early. / Ações de imunização são importantes para a redução da mortalidade infantil, um dos objetivos de desenvolvimento do milênio. Para isso, é essencial que as coberturas vacinais estejam de acordo com a recomendação do Ministério da Saúde. Dados produzidos nos serviços de vacinação são inconsistentes e há divergências quantos aos fatores associados à vacinação infantil. O estudo objetivou avaliar os fatores associados à incompletude do calendário básico de vacinação (CBV) e esquema vacinal para novas vacinas (EVNV) (meningocócica C e pneumocócica 10) em crianças de 13 a 35 meses de idade, de uma coorte de nascimento, em São Luís, Maranhão, Brasil. Amostra foi probabilística no momento do nascimento, composta de 3.076 crianças do seguimento, nascidas no ano de 2010. Informações sobre a vacinação foram obtidas a partir da caderneta de saúde da criança. As vacinas consideradas para o CBV consistiram em BCG, hepatite B, pólio, tetravalente, rotavírus, febre amarela e tríplice viral e para EVNV, meningocócica e pneumocócica. Realizou-se análise hierarquizada, com regressão de Poisson com ajuste robusto da variância. Foram estimadas razões de prevalência (RP) e respectivos intervalos de confiança a 95% (IC95%). O CBV foi incompleto em 33,2% das crianças e EVNV em 51,1%. Maiores proporções de incompletudes tanto para CBV, quanto para EVNV ocorreram em crianças cujas mães eram adolescentes (CB: RP=1,26 e IC95% 1,10-1,45; NV: RP=1,15 e IC95% 1,05-1,27), residiam com outros filhos (CB: RP=1,32 e IC95% 1,17-1,49; NV: RP=1,29 e IC95% 1,19-1,40 com um; CB: RP=1,55 e IC95% 1,34-1,80; NV: RP=1,33 e IC95% 1,24- 1,52 com dois a três; CB: RP=1,81 e IC95% 1,41-2,33; NV: RP=1,36 e IC95% 1,11-1,67 com mais de três), fumavam (CB: RP=1,52 e IC95% 1,28-1,82; NV: RP=1,22 e IC95% 1,07-1,40), não planejaram a gravidez (CB: RP=1,18 e IC95% 1,05-1,31; NV: RP=1,09 e IC95% 1,00- 1,10), engravidaram logo após o nascimento da criança em estudo (CB: RP=1,22 e IC95% 1,04-1,43; NV: RP=1,16 e IC95% 1,03-1,29), realizaram poucas consultas de pré-natal (CB: RP=1,25 e IC95% 1,11-1,40; NV: RP=1,15 e IC95% 1,06-1,25) e o iniciaram tardiamente (CB: RP=1,40 e IC95% 1,06-1,86; NV: RP=1,27 e IC95% 1,07-1,52). Indicadores de vulnerabilidade sociodemográficas e comportamentais, e baixa utilização dos serviços de pré-natal foram associados à incompletude vacinal infantil. Sugere-se considerar essas vulnerabilidades nas estratégias de vacinação, a fim de contribuir para o alcance de altas coberturas vacinais tanto do calendário básico, quanto de novas vacinas introduzidas na vacinação infantil, e com isso, possibilitar à população infantil maior proteção contra as doenças imunopreveníveis. Além de oportunizar que as gestantes realizem mais consultas de pré-natal e o iniciem precocemente.
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Juggling with dilemmas when promoting public health : Nurses´ and physicians´ motivating strategies towards vaccine hesitant parentsIvarsson Markus, Linda January 2014 (has links)
Background: To achieve control of a vaccine preventable communicable disease, it is of importance to establish high enough coverage to reach the threshold for herd immunity. Preventive public health interventions, such as vaccination programmes, create dilemmas between societal versus individual benefits of the programme. Vaccine providers handle this dilemma when motivating hesitant parents and vaccine providers´ own perceptions of vaccine benefits will possibly influence the parental decision. The motivating strategies need to support parental autonomy, the best interest of the child and societal benefits. By using the bioethical principles autonomy, beneficence and justice, strategies can be analyzed regarding what agents are most benefitted by the strategy. Purpose: To gain insight in how vaccine providers balance between individual, societal, parental and internal values when promoting vaccine towards vaccine hesitant parents. Method: Explorative qualitative interview study. Results: The respondents´ strategies are more or less influencing and adjusted according to the underlying reason the parents have for hesitation. An underlying strategy is to use means of social interaction to build trustful relationships. Respondents perceived reasons to vaccinate are ranging from individual to societal and are reflected in the strategies and the respondents aim to aid parents to a well informed decision. Some strategies are more persuasive than others and in rare occasions infringe on parental autonomy in a less plausible manner. Conclusions: The findings from this study reflect that the public health dilemma is indeed present in the clinical context when motivating vaccine hesitant parents. Respondents do their utmost to aid the parents to a well informed decision, regardless if the child will be vaccinated or not, or whatever reason parents have for hesitance. Since vaccination is a voluntary action that is required from many to reach herd immunity, vaccine providers need to consider the ethics surrounding motivating hesitant parents to reach best possible outcome regardless if this is benefitting the child, society or parental autonomy / Bakgrund: För att kunna kontrollera vaccinerbara smittsamma sjukdomar är det av högsta vikt att etablera hög vaccintäckning och uppnå nivån för flockimmunitet. Preventiva folkhälsointerventioner, såsom vaccinationsprogram, skapar dilemman mellan samhällelig och individnytta. Yrkespersoner som erbjuder vaccin måste hantera detta dilemma när de motiverar föräldrar som är tveksamma till att vaccinera sina barn. Yrkespersonernas uppfattningar om nyttan med vacciner och motivationsstrategierna kan tänkas påverka föräldrarnas beslut. Strategierna behöver stödja såväl föräldrarnas autonomi, barnets rätt och samhällets bästa. Genom användande av de bioetiska principerna autonomi, godhet och rättvisa kan strategierna analyseras utifrån vilka agenter som gagnas mest. Syfte: Att få inblick i hur yrkespersoners balanserar mellan individuella, samhälleliga, föräldrarelaterade och interna värden när de promotar vaccin till föräldrar som är tveksamma till vaccin. Metod: Explorativ kvalitativ intervjustudie. Resultat: Respondenternas strategier anpassas efter föräldrarnas bakomliggande skäl till att inte vaccinera sina barn och är mer eller mindre influerande. En underliggande strategi är att använda social interaktion för att bygga förtroende hos föräldrarna. Respondenterna uppfattade nyttan med vacciner som både individuell och samhällelig och speglades i strategierna. Respondenterna siktade på att föräldrarnas beslut ska vara välgrundat. Några strategier är mer övertalande än andra och i sällsynta fall inkräktande på föräldrarnas autonomi på ett mindre lämpligt sätt. Slutsats: Fynden speglar att folkhälsodilemmat mellan individ och samhälle är närvarande i den kliniska situationen när tveksamma föräldrar ska motiveras till att vaccinera sina barn. Respondenterna gör sitt yttersta för att guida föräldrarna till ett välgrundat beslut, oavsett om barnet blir vaccinerat eller inte, oavsett vilket skäl föräldrarna har till tveksamheten. Eftersom att vaccination är en frivillig handling som krävs av många för att uppnå flockimmunitet så behöver yrkespersoner ta hänsyn till etiken kring när föräldrar motiveras till att vaccinera sina barn. Detta för att uppnå bästa möjliga resultat oavsett om det gagnar barnet, samhället eller föräldrarnas autonomi.
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Randomized controlled trial of low cost interventions to reduce childhood immunization dropouts in PakistanUsman, Hussain Raza. January 2008 (has links) (PDF)
Thesis (D.P.H.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Sept. 22, 2008). Includes bibliographical references.
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Uma contribuição à história do combate à varíola no Brasil: do controle à erradicação / A contribution to the history of smallpox fight in Brazil: from control to eradicationGazêta, Arlene Audi Brasil January 2006 (has links)
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Previous issue date: 2006 / Discute as políticas públicas contra a varíola no Brasil, centrando-se nas campanhas para o seu controle e erradicação - Campanha Nacional Contra a Varíola (1962) e Campanha de Erradicação da Varíola (1966). Inicialmente, analisa a história dessa doença no país, observando sua importância epidemiológica e seu significado simbólico como mal epidêmico de grande mortalidade em diversos momentos. A partir dessa análise, procura identificar os fatores que a transformaram em alvo de uma campanha de erradicação.
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Analise do programa de vacinação dos idosos no municipio de Campinas, SPReis, Priscilleyne Ouverney 14 December 2004 (has links)
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Previous issue date: 2004 / Resumo: Esta pesquisa objetivou compreender o desenvolvimentodo Programa de Vacinação de Idosos em Campinas-SPentre os anos de 1999 e 2004, sob o foco das práticas adotadas pelas instâncias central, distrital e local na conformação das coberturas vacinais alcançadas.O método de estudo de caso foi utilizado, tendo
como fonte primária os registrosde entrevistas realizadascom sete trabalhadores dos três níveis da Secretaria Municipal de Saúde, que estavam diretamente envolvidos na coordenação da campanha,e como fontes secundáriasos registros e documentos sobre o tema. Tanto os agentes distritais como os locais,
responsáveis pela coordenação da campanha, eram enfermeiras. Caracterizamos o planejamento,o desenvolvimentoe a avaliação da Campanha no ano de 2004 com o propósito de relacioná-Ios aos resultados atingidos. Para tal, realizamos cálculos das coberturas vacinais de 1999 a 2003 para município, Distritos de
Saúde (DSs) e Unidades Básicas de Saúde (UBSs) a partir dos dados de número de doses aplicadas e tamanho da população-alvo disponibilizadas pela Coordenação de Vigilância em Saúde (CoVISA). As coberturas vacinais na totalidade do município, nos DSs e UBSs, entre os anos assinalados, apresentaram significativa variabilidade. Dois DS foram eleitos para estudo em virtude de comportamentos mais estáveis no que dizia respeito às coberturas vacinais alcançadas no referido período e, posteriormente,uma UBS foi escolhida devido a seu comportamento particular e à indicação de técnicos do respectivo nível distrital. Identificamosque o processo de trabalho desenvolvido nas diversas instâncias não eram compatíveiscom os objetivos e finalidades da campanha. Da mesma forma, pudemos constatar que em todos os níveis, as atividades de planejamento se restringiram ao cumprimento de rotinas relativas à transmissão . de dados. Pudemos observar também que a vacinação foi assumida, exclusivamente,em sua dimensão técnica e manual, que a educação em saúde ficou limitada à elaboração de cartazes de divulgação e que a singularidade do
idoso não foi considerada nas práticas desenvolvidas. Notamos ainda que a análise de coberturas vacinais não foi utilizada como instrumento de avaliação, tampouco foi adotada como instrumento de trabalho nas ações gerenciais. Palavras Chave: avaliação de programas - programas de imunização - idosos - gerência / Abstract: This research had as objective to comprehend the development of the years, from the analysis adopted by the central, districtal and local instances in the coverages' conformation results reached. The case-study method was used, having as primary source the interview notes performedwith seven workers placed
on the three organizational levels of the Municipal Health Secretary, that were directly involved in the campaign coordination,and as second source the several records and documents about the subject. Both the districtal and local agentes in charge of coordination were nurses. The planing, the development and the evaluation of the 2004 year campaign was characterizedwith the finality of related them to the results obtained. For this task we calculated vaccinal coverages between 1999 and 2003 years for municipal district, Health Districts (DSs) and
Basic Health Units (UBSs) trom aplied dosis number and target-population size data supplied by the Health Vigilance Bureau (CoVISA). The vaccinal coverage in the whole municipal district, in the DSs and in the UBSs, for the already mentioned years, showed a significant variability. Two DSs were elected for this study due to
their more stable behavior respect to the coverages and after we chose one UBS due to his particular behavior and also because of districtal worker's indication. It was identified that the work process developed at the severaI instances weren't compatible with the campaigns' objectives and finalities. In addition, it was verified in ali levels that the planning activities were restricted to the routines acomplishment related to the simple data casting. It was also possible to observe that the vaccination-was assumed exclusively in his manual and technical
dimension, that the information of health was limited to the divulgation's material elaboration, and that the elderly singularities wasn't considered in the developed practices. It was noted still that the vaccinal coverage analysis nor was used as a evaluation toei neither was adopted as a work tool in the management actions. Key-works: Program Valuation; Imunization Program; old-aged; management / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem
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