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Previous issue date: 2008-12-29 / Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority.
Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also
perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of
cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research
elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling,
family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme.
Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference.
But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong
influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and
evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to
the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty / A Declara??o de Alma-Ata trouxe a Aten??o Prim?ria ? Sa?de (APS) como o primeiro n?vel de aten??o em sa?de para indiv?duos, fam?lia e comunidade, o qual considera o grupo infantil como priorit?rio. Diversas iniciativas deram bases para aten??o integral ? sa?de da crian?a formalizada nos
princ?pios do Sistema ?nico de Sa?de (SUS). A Estrat?gia Sa?de da Fam?lia (ESF) vem fortalecer essa aten??o, instituindo novas formas de organiza??o do trabalho e pr?ticas profissionais que impactam nos seus indicadores de qualidade. Sendo um deles a mortalidade infantil, ao apresentar decl?nio de seus valores. Todavia, estudos indicam a persist?ncia de ?bitos infantis evit?veis. Em Natal RN, esta realidade tamb?m ? percept?vel, gerando inquieta??es rincipalmente, no espa?o da produ??o dos servi?os, o que motivou a realiza??o do presente estudo com vistas a analisar de que modo os processos organizacionais e estruturais, bem como, a pr?tica dos profissionais na ESF interferiram na qualidade da aten??o ? sa?de das crian?as que foram a ?bito evit?vel no ano de 2007, no munic?pio de Natal-RN. Trata-se, portanto, de uma pesquisa explorat?ria e descritiva do tipo estudo de casos, que tomou como fontes prim?rias os ocumentos oficiais do MS; o prontu?rio da fam?lia, cart?o da
gestante, e da crian?a e os depoimentos obtidos a partir do instrumento de pesquisa elaborado com base na ficha de investiga??o de ?bito infantil do MS, aplicado a 10 m?es das crian?as que foram a ?bito evit?vel. Na an?lise recorreu-se a triangula??o simult?nea de m?todos e fontes, permitindo
uma maior aproxima??o das informa??es obtidas. Para elucidar os casos, os aspectos estudados foram analisados ? luz do modelo explicativo dos Determinantes Sociais da Sa?de. Dentre os aspectos individuais e familiares ressaltaram os relacionados ? idade, escolaridade, h?bitos e costumes
familiares e condi??o econ?mica da m?e, al?m da idade gestacional, peso do neonato e doen?as associadas, os quais n?o diferem da literatura sobre o tema. Quanto aos fatores organizacionais, estruturais e a pr?tica dos profissionais, ressaltam-se o tratamento dispensado pelos profissionais, a
territorializa??o e adscri??o de ?reas, a dificuldade de acesso aos servi?os ou leitos e a refer?ncia e contra refer?ncia. Mas tamb?m, a aus?ncia ou pouco acolhimento, a falta de comunica??o, a pouca assiduidade e pontualidade dos profissionais no servi?o, dentre outros. De maneira geral as m?es consideraram o atendimento recebido no hospital bom e muito bom , opini?es que na Aten??o B?sica n?o foram t?o favor?veis, apesar de que muitas das a??es previstas nesse n?vel de aten??o tenham sido realizadas nos casos estudados. Observa-se, portanto, que os determinantes sociais da sa?de exercem forte influ?ncia na ocorr?ncia dos ?bitos infantis. Desse modo, torna-se fundamental a reflex?o e a avalia??o acerca da efetiva??o e efic?cia dos processos de vigil?ncia ? sa?de nas USF; o repensar sobre os determinantes sociais da sa?de de forma ampliada e articulada ? qualidade dos servi?o, ? educa??o permanente, ? gest?o em servi?o, ? aten??o dispensada e ? forma como se instala a participa??o popular e o controle social. Para os profissionais apresenta-se o grande desafio de rever a sua pr?tica cotidiana, seus valores, comportamentos e compromissos, os quais devem orientar-se pela l?gica do compartilhamento, do trabalho em equipe, da humanesc?ncia e alteridade e n?o apenas do cumprimento de um dever profissional
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/14684 |
| Date | 29 December 2008 |
| Creators | Oliveira, Ariane Rose Souza de Macedo |
| Contributors | CPF:12355844453, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4760582E9&dataRevisao=null, Enders, Bertha Cruz, CPF:25444816415, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4781295D6&dataRevisao=null, Monteiro, Akemi Iwata, CPF:08449740487, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794971Y1&dataRevisao=null, Collet, Neusa, CPF:14468166053, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4795273E3, Tim?teo, Rosalba Pessoa de Souza |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Enfermagem, UFRN, BR, Assist?ncia ? Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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