Epidemiologia e organização de serviços: a experiência com o sistema de informações sobre nascidos vivos no município de Manhuaçu, Minas Gerais

Abstract

Epidemiology together with the planning and other social sciences have been recognized as necessary to the structuring of a new model of attention to health, taking into account the answering to the existing demand and the incorporation of the epidemiological knowledge in the organization of health services. This study tries to identify the contribution of the epidemiology in the organization of services via Sistema de Informações sobre Nascidos Vivos - The Information System on Live Births (SINASC) in the district of Manhuaçu, Minas Gerais, place of search. The objectives of this work are to analyze the process of implementation and its relation with the organization of health services, to characterize the implantation of the process, to analyze the use of SINASC in the organization of service, and to evaluate the information given by this system according to the variations of weight of birth, birth of age, pre-born consultations, and kind of delivery. The draw of the study is a study of case, being it a descriptive exploration with two approaches, one quantitative and the other qualitative. The period of the research is the historical series from 1996 to 2006, in which 1996 is the year of implantation of SINASC in the district being studied. The sources of study are SINASC, interviews with professionals of health, and documents from Manhuaçu Municipal Secretary of Health. I worked with the data selected from the declarations of the live born, weight of birth, birth of age, pre-born consultations, and kind of delivery. To present a valid study a lifting of data is used in order to make it possible to compare various perceptions obtained from diverse sources, using different techniques to collect data. This study was approved by the Committee of Ethics and Research of Universidade Federal de Minas Gerais in 08/29/2007 Process no 0234.0.203.000-07. The results found demonstrate that the indicators of SINASC show improvements in the period, being the quality of information the most significant, displaying grater commitment from the ones involved to the system. However, there is still lack of clarifying about the importance of the proper filling out to an efficient plan in the health area, according to the population necessities not just to the duty of achieving goals to receive support. In the discussion of the category referring process of organization of SINASC we see that most of the professionals do not know the implantation, but recognize SINASC as something important to the organization of service. The study of the category of the process of SINASC allows us to identify lack of knowledge about the process, difficulties in the performance of actions and different perceptions of the same situation. The approach of the use of SINASC in the organization of service presents the debility of the use of a system of information, with lack of structure of the services related to the systematization of actions, and an economist view of the use of the system in the worth of agreements. I hope this study holds discussions about improvement in the quality of aid to deliveries and motivates the use of SINASC as an instrument of accompaniment of the mother-infant conditions in the district.