Desafios no atendimento à Saúde da Criança por médicos da Estratégia de Saúde da Família

Abstract

Child health care by physicians of the Family Health Strategy (ESF) is based on recommendations of the Ministry of Health and the Brazilian Society of Family and Community Medicine. It is necessary to identify the difficulties of the physicians of the ESF to offer assistance in Child Health in the municipality of Patos de Minas-MG, since the assistance in Primary Care is provided by the ESF in almost all the territory of this municipality. A structured questionnaire was applied to the 42 physicians who work at the ESF, with specific questions related to the professional profile and the ESF team in which it is inserted, and regarding child health care actions in the anamnesis, physical examination, laboratory tests and orientations. A descriptive analysis of the absolute and percent frequencies of the categorical variables was made; and the means and standard deviation of the metric variables. Thirty-two physicians (76.2%) answered the questionnaire. The main reason for the doctors to be in the ESF was interest in the work of Primary Care (78%).The most frequent difficulties related to the team were the lack of fulfillment of childcare groups (40.6%) and the absence of child care shared with the nurse (40.6%). Participants pointed out that clinical skills and family approach are factors that make it difficult to perform childcare appointments. The difficulties presented by the physicians were related to the skills in the physical examination of the newborn, mainly eye examination (59.3%), hearing (62.5%) and neurological evaluation (53.1%). Among ophthalmologic tests in childhood, the difficulty ranged from 68.7% for visual acuity to 93.7% for the coverage test. Difficulties related to inadequate physical structure and / or lack of equipment occurred for the Eye Test (34.4%) and for the blood pressure measurement (68.6%). Difficulties due to ignorance of recommendations of the Ministry of Health occurred with anemia screening (15.6%) and lipid profile screening (40.6%). Regarding the orientations, 15.6% of physicians do not address Body Mass Index (BMI) curves with families, and 18.7% do not approach issues related to various forms of violence in childhood. The difficulties identified in physicians regarding clinical skills, may be related to the quality of undergraduate training, which occurs because it does not emphasize all the necessary competences for adequate assistance in Child Health in Primary Care, as well as the absence or ineffectiveness of permanent education during professional practice. Childcare in Patos de Minas presents flaws, which are related to the frailties of physicians, the physical structure and equipment and the teams of Family Health Strategy.