Centros viva vida de referência secundária: um estudo de caso da atenção pediátrica

Abstract

Public policies related to child health and reducing infant mortality are not new in Brazil. Despite all the progress, the infant mortality rate is still at levels considered unacceptable, requiring the formulation of consistent public policies to confront this situation. The current strategy of Minas Gerais to reduce this indicator is the Programa Viva Vida. Among the actions developed by this program, we highlight the establishment of the Centros Viva Vida de Referência Secundária (CVV). This study aims to evaluate the pediatric care provided by one CVV, in its first two years of operation, using as reference the terms agreed for its implementation. For this, a quantitative and qualitative approach was used. In the quantitative component, a cross-sectional study was performed, using a stratified random sample of medical records of pediatric patients enrolled in the CVV of Brasília de Minas between 2007 and 2009. Data were analyzed with the statistical package Epi Info 6.04 and the level of significance was 5%. The qualitative component drew on focus group as the main technique for data collection to be used for the analysis related to strategic actors perceptions on the role of CVV and its insertion into the network. An exhaustive reading of the material was done with its systematization on the categories: knowledge about the CVV proposal, use of the CVV, relationship between CVV and Primary Health Care, relationship between guidelines and reality of the contracted service. The results indicated difficulties in organizing the service contracted according to the guidelines. Differences were observed between the users of the CVV and the audience provided in relation to age, county of origin and clinical features. There are also differences between the services offered assistance and guidelines agreed upon. Access to and use of CVV services are not homogeneous among the throughout the region. The main barriers highlighted by the strategic actors, among others, were unaware of the CVV proposal by professionals of the primary health care, transport difficulties and weaknesses in the care network deployed in the region. Despite these problems, the actors support the innovative aspect of the CVV and believe that it´s an important initiative for expansion and organization of the health care of children in Minas Gerais. It is concluded that the CVV proposal as planned, is not observed in the practice, indicating the need for interventions, to ensure that expected results are achieved.