Avaliação do acesso e da utilização de serviços de saúde pela população quilombola de Vitória da Conquista, Bahia

Abstract

Introduction: access is a multidimensional concept associated with the characteristics of the supply of health services to indicate the degree of ease or difficulty with people obtain health care, The use of health services is a positive expression of access and therefore can be used as an indicator of access to health care. The access and use of health services in the country are increasing but remain geographic and social inequalities, especially in minority groups. Objectives: to evaluate the access and use of health services by members of quilombos (slave-descendents African-Brazilian communities) in Vitória da Conquista, Bahia Satate, Brazil. Methods: it is cross-sectional study, conducted in 2011, part of a health survey called COMQUISTA Project, which investigated the health conditions, access and utilization of health services in quilombos communities in the region of Vitória da Conquista, Bahia. The communities were Corta Lote, Maria Clemência, Furadinho, Lagoa de Melquíades and Boqueirão. The study population consisted of three groups of subjects 1) adults (> 18 years) residing in these communities, 2) community leaders who worked and exercised leadership role and 3) professional teams of the Family Health reference these communities. This study used a triangulation of methods, particularly recommended approach to evaluation studies. In quantitative analysis the magnitude of the associations between explanatory variables and the use of services was estimated the prevalence ratios obtained by Poisson regression with the 95% confidence level. Regarding qualitative data, their analysis was based on the Theory of Social Representations and Content Analysis. Results: of the total sample, 455 (57.1%) reported having used health services in the 12 months prior to the interview. Higher rates of health services utilization were associated with female gender, non-single conjugal status, who rated their health as fair, poor, or very poor, registered in the Family Health Program, and referred to a health facility for regular or on-going care. Members of quilombos showed poorer access to health services related to the presence of physical barriers, socio-cultural and financial, to the insufficient knowledge of the users and the inadequate quality of care. Conclusion: the results showed greater difficulty of access and lower utilization of health services by the quilombo population in Vitória da Conquista, Bahia. Therefore it is recommended: expand/improve the physical infrastructure of health services, deploy new Family Health Teams; investment in the stability of working linkis in the area of health promotion; upgrade information systems in health and create specific health indicators for monitoring the health status of the health status of the members of quilombos.