Doutorado em Saúde Coletiva

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Navegando Doutorado em Saúde Coletiva por Assunto "Acesso aos serviços de saúde"

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    Acesso à saúde da mulher na atenção primária: marcadores e interseccionalidades
    (Universidade Federal do Espírito Santo, 2021-05-17) Barbosa, Bruna Ligia Ferreira de Almeida; Lima, Rita de Cássia Duarte; https://orcid.org/0000-0002-5931-398X; http://lattes.cnpq.br/2384472795664270; https://orcid.org/000000020085049X; http://lattes.cnpq.br/7266254969244866; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; Dias, Jerusa Araújo; https://orcid.org/0000-0002-0490-2488; http://lattes.cnpq.br/4947139217720033; Leite, Franciele Marabotti Costa; https://orcid.org/0000000261716972; http://lattes.cnpq.br/7170760158919766; Lima, Eliane de Fatima Almeida; https://orcid.org/0000-0001-5128-3715; http://lattes.cnpq.br/4640538188376728; Dawson, Angela; https://orcid.org/0000-0003-0926-2202
    Introduction: The reality about the health problems that women have been experiencing in Brazil, evidences the denial of comprehensiveness, insofar as it requires embracement, sensitive listening, access, continuity, and resolution. The existence of social markers, whether of race, economic, social, and educational status, places women in a situation of vulnerability, reflecting on access to Primary Health Care services. In this perspective, considering that women are the majority among the Primary Health Care users, their experiences must be contextualized, respecting the singularities and recognizing their conditions of vulnerability, in order to alleviate the inequalities that interfere in the access and use of health services. Objective: Analyse the access to and utilization of services aimed to women’s health into the Primary Health Care system in the state of Espírito Santo. Methodology: Descriptive study, with a qualitative approach, carried out in women users of Primary Health Care, from October 2020 to January 2021, in five municipalities that represent the health regions of Espírito Santo, plus the capital Vitória. A questionnaire with sociodemographic information of the users and a script guided by the theoretical framework of access and use of health services by McIntyre and Mooney (2007) was used. For data analysis, the Thematic Analysis technique by Bardin (2011) was used, which consists of three stages: data pre-analysis, resource exploration, and data interpretation. Results: Barriers were identified with regard to availability, acceptability and ability to pay for access to services offered in Primary Health Care. These barries are present mainly in relation to referral to specialized services, reception, health promotion actions and diagnostic tests. In addition, the different levels of information between the service teams and the users, were related to a greater or lesser extent to the access and use of health services, especially regarding mammography. Final considerations: There are factors that interfere with access to primary care services, reflecting the inequalities among women. The race/color, gender and social class cuts reflect and reveal the structural/institutional racism that shapes our society, highlighting the inequalities faced by women when accessing, among others, health services.Propositional strategies for reorganizing women's health policies are necessary in order to overcome barriers and enable greater access and use of women to primary care services.
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    O enfrentamento da tuberculose em migrantes internacionais e refugiados no Brasil
    (Universidade Federal do Espírito Santo, 2022-08-18) Jezus, Sonia Vivian de; Maciel, Ethel Leonor Noia; https://orcid.org/0000000348263355; http://lattes.cnpq.br/3761398932271892; https://orcid.org/0000-0002-0423-8927; http://lattes.cnpq.br/0820815379109713; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; Lima, Rita de Cassia Duarte; http://lattes.cnpq.br/2384472795664270; Novais, Liliane Capilé Charbel; https://orcid.org/0000-0002-9989-2349; http://lattes.cnpq.br/2662755913656148; Silva, Adriana Ilha da; http://lattes.cnpq.br/4088542085942883; Arcencio, Ricardo Alexandre
    Background: Migrants are a high priority group for tuberculosis control measures due to their high exposure to risk factors such as poverty and social vulnerability. Objectives: Understanding the TB illness process in international migrants, refugees and asylum seekers from the perspective of critical epidemiology; to identify barriers and facilitators for combating tuberculosis in international migrants, refugees and asylum seekers; identify factors associated with latent tuberculosis among international migrants living in four Brazilian state capitals and analyze a Local Action Plan to promote access to the health system of indigenous Venezuelans from the Warao ethnic group in Manaus, Brazil. Methods: In the review, 10 studies were included and two empirical categories emerged: barriers (11) and facilitators (10). (2) cross-sectional study, carried out in September and October 2020, with 903 international migrants, residing in four Brazilian capitals: Boa Vista / RR (458), Manaus / AM (136), São Paulo / SP (257), and Curitiba / PR (52). Data were collected with a questionnaire consisting of open and closed questions on personal characteristics, information on tuberculosis, and use of preventive measures. Tuberculin skin test was performed, with reading after 72 h by trained nurses and using 5 mm induration as the positive cutoff. Chi-square test (X2) and Fisher's exact test, both two-tailed, were used to compare statistically significant levels of association between the migrants´ sociodemographic characteristics, vulnerability, and latent tuberculosis infection. Binary logistic regression was applied to calculate odds ratios and respective 95% confidence intervals. For all the tests, type I error of 5% was defined as statistically significant (p < 0.05). (3) a mixed methods study, with quantitative data and a selfcompleted questionnaire by health professionals; and qualitative with an interview script with the Warao sheltered in Manaus. Descriptive statistics, cluster analysis (GA) by hierarchical levels and multiple correspondence analysis (MCA) were applied. Content analysis was applied to qualitative data. Results: In the review, 10 studies were included and two empirical categories emerged: barriers (11) and facilitators (10). In article 2, the prevalence of latent tuberculosis among migrants was 46.1% in Manaus/AM, 33.3% in São Paulo/SP, 28.1% in Curitiba/PR, and 23.5% in Boa Vista/RR. Factors associated with latent infection were age, male gender, and brown or indigenous race. In article 3, 106 healthcare providers participated in the study, with the following characteristics: 94 (88.7%) females, 67 (63.2%) pardo race/color, 40 (37.7%) working in primary healthcare, and 49 (46.2%) nurses. In addition, 43 (40.6%) of the healthcare providers reported providing care to warao. Among the providers, 89 (84%) had received training for assisting warao. Additionally, 30 warao were enrolled for interviews in the qualitative phase. The barriers to seeking care were language, distance to health units, and lack of money for transportation. Conclusion: The study showed that there are several barriers and facilitators for coping with tuberculosis, high prevalence of tuberculosis infection among international migrants. The local care plan has proven to facilitate access to the health system for indigenous Venezuelans of the Warao ethnic group in Manaus and improve access to the health system.