Análise da trajetória assistencial de crianças nascidas na pandemia de COVID19, com suspeita e/ou atraso do desenvolvimento no sistema de saúde do Estado de Minas Gerais

Abstract

The COVID-19 pandemic impacted child development, especially in early childhood, by exacerbating inequalities and hindering access to essential health services. The reduction in stimuli, social interactions, and clinical follow-up significantly compromised global development. In this scenario, child development monitoring and early intervention became even more crucial to ensure comprehensive healthcare for children. Despite the issuance of reports of suspected and/or delayed development that could facilitate timely access, structural and organizational barriers persist, limiting the continuity and effectiveness of specialized care. This cross-sectional study, nested in a cohort involving five municipalities in Minas Gerais, Brazil, with a quantitative approach, aimed to investigate the healthcare trajectory of children born during the COVID-19 pandemic who were referred to health services due to suspected and/or diagnosed developmental delay. A total of 61 mothers of children with suspected developmental delay, identified through the SWYC-BR screening test and/or diagnosed according to the Bayley-III scale at 24 months of age, were interviewed. Actions taken after receiving the report with the evaluation results, health service utilization, time to initiation and frequency of care, as well as satisfaction with the healthcare pathway, were investigated through a telephone questionnaire. Among the mothers included, 42 (69%) sought healthcare services after receiving the report. In the private sector (n=10), all children were evaluated, 70% accessed specialized care, and most belonged to higher socioeconomic classes (90%). In the public sector (n=32), the majority belonged to lower socioeconomic classes (84%); of these, 25% were still awaiting evaluation, and among those already evaluated, only 46% had started specialized follow-up. The most accessed specialties were physiotherapy, speech therapy, and psychology, with wide variation in initiation time and frequency of sessions. Nineteen mothers (31%) did not seek any form of healthcare, and most belonged to low or very low socioeconomic classes (79%); of these, 30% reported dissatisfaction with their experience in the public health system. This study revealed significant barriers in access and continuity of care, as well as inequalities between the public and private sectors. The findings highlight the need for effective integration of healthcare networks and for further studies to deepen the understanding of family experiences, in order to support the improvement of public policies aimed at child development.