Atenção Primária em Saúde: modelo provedor de qualidade na atenção à saúde da criança em Ponta Grossa/PR

Abstract

In Brazil, Primary Health Care (PHC) expanded in the mid-1990s with the implementation of the Family Health Program (FHP), which was elevated to the Family Health Strategy (FHS) in 1997, aiming for a comprehensive approach to individuals. This model has consolidated child health in the country, making significant progress in reducing infant mortality. Thus, this thesis aims to evaluate the presence and extent of the attributes of Primary Health Care in the care of children aged zero to two years enrolled in the FHS in the municipality of Ponta Grossa.To achieve the study's objectives, a qualitative-quantitative research approach was designed. A total of 358 families, with children aged zero to two years, users of the FHS in the municipality participated, with respondents being parents, mothers, or caregivers, of which 20 composed the qualitative sample. Data collection occurred in health units from July to December 2023, and involved sociodemographic characteristics. To measure the presence and extent of PHC attributes in the FHS, the Primary Care Assessment Tool - PCATool-Brazil child, extended version was used. Data were analyzed using free software PSPP 1.3.0 and the Collective Subject Discourse (CSD) technique.The research results indicate that child care in the municipality is oriented towards PHC, represented by Essential and General scores ≥6.6, with higher scores in the components 'Information System', 'Provided Services', 'Utilization', 'Care Integration', 'Longitudinality', 'Affiliation', and 'Family Orientation'. The attributes 'Accessibility', 'Available Services', and 'Community Orientation' were unsatisfactory, characterized by scores <6.6. The identification of the FHS as the reference service for child health care was observed, but acute care is concentrated in Emergency Care Units (UPAs), lacking homogeneity in the use of child care services, access to consultations, and communication tools, available services, follow-up care by the same professional, highlighting the turnover of doctors, and weaknesses in referral and counter-referral.The results highlighted how PHC fulfills its role as the "gateway" to the maternal and child care network in the municipality. Thus, the challenge for health unit teams was identified to maintain the strengths in child care and the need to implement strategies to address the weaknesses identified to defend more equitable and qualified child health, promoting better indicators.