VULNERABILITY IN THE CHILD DEVELOPMENT: INFLUENCE OF PUBLIC POLICIES AND HEALTH PROGRAMS*
DOI:
https://doi.org/10.7322/jhgd.96760Palavras-chave:
health vulnerability, child development, public health policy, primary health care, nursingResumo
Introduction: vulnerability in child development can defined as the chance or opportunity to the child to suffer losses or delays in their development due to the influence of individual, social, and programmatic factors, which constitute adverse situations. Objective: to characterize the programmatic dimension of vulnerability in child development, according to the nurse at the Family Health Strategy Program. Methods: a qualitative exploratory study, conducted with nurses from units with the Family Health Strategy, in a city of the southern region of Brazil. Data collected by semi-structured interviews and analyzed according to the dialect hermeneutic and analytic matrix of the vulnerability of children in adverse situations for their development. Results: participants were 39 nurses, one from each health unit, who described budgetary, institutional, administrative and care factors that influence the process of health care and relate to the promotion of child development. Even acknowledging improvements in the current scenario of healthcare, they classified such factors as insufficient. Thus, the categories Fragilities in political-programmatic scenario and Gaps in the programmatic-assistance implementation, explain the vulnerability of the child health care in programmatic dimension, which characterizes a potentially injurious situation to the development. Conclusion: The nurses understand that the programmatic dimension of health care shows up as a significant cause of vulnerability in the development of the child.
Downloads
Referências
AJ Barros, C Ronsmans, H Axelson, Loaiza E, Bertoldi AD, França GVA, et al. Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries. Lancet. 2012; 379 (9822): 1225-33. Doi: http://dx.doi.org/10.1016/S0140-6736(12)60113-5.
Shonkoff JP, Garner AS, Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, Section on Developmental and Behavioral Pediatrics. The Lifelong Effects of Early Childhood Adversity and Toxic Stress. Pediatrics. 2012; 129(1): 232-46. Doi: http://dx.doi.org/10.1542/Peds.2011-2663.
Atrash HK. Childhood Mortality. Still a global priority. J Hum Growth Dev. 2013; 23(3): 257-260.
Shonkoff JP. Protecting brains, not simply stimulating minds. Science. 2011; 333(6045): 982–83. Doi: http://dx.doi.org/10.1126/Science 1206014.
Mazza VA, Chiesa AM. Family needs on child development in the light of health promotion. Online Braz J Nurs. 2008; 7(3). Doi: http://dx.doi.org/10.5935/1676-4285.20081852.
Victora CG, Hallal PC, Araújo CL, Menezes AM, Wells JC, Barros FC. Cohort profile: the 1993 Pelotas (Brazil) birth cohort study. Int J Epidemiol. 2008; 37(4): 704-709. Doi: http://dx.doi.org/10.1093/ije/dym177.
Martorell R, Nguyen P. Interrelationship between growth and development in low and middle-income countries. Nestle Nutr Workshop Ser Pediatr Program. 2010; 65: 99-118. Doi: http://dx.doi.org/10.1159/000281151.
Pedroso MLR, Motta MGC. A compreensão das vulnerabilidades socioeconômicas no cenário da assistência de Enfermagem pediátrica. Rev Gaúcha Enferm. 2010; 31(2): 218-24. Doi: http://dx.doi.org/10.1590/S1983-14472010000200003.
Silva DI, Chiesa AM, Veríssimo MLOR, Mazza VA. Vulnerability of children in adverse situations to their development: proposed analytical matrix. Rev Esc Enferm USP. 2013; 47(6):1397-402. Doi: http://dx.doi.org/10.1590/S0080-623420130000600021.
Cherchiglia ML, Dallari SG. A reforma do Estado e o setor público de saúde: governança e eficiência. Rev Adm Pública. 1999; 33(5): 65-84.
Feuerwerker LM. Modelos tecnoassistenciais, gestão e organização do trabalho em saúde: nada é indiferente no processo de luta para a consolidação do SUS. Comunic Saúde Educ. 2005; 9(18): 489-506.
Countdown Coverage Writing Group, Countdown to 2015 Core Group, Bryce J, Daelmans B, Dwivedi A, Fauveau V, et al. Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking
coverage of interventions. Lancet. 2008; 371(9620): 1247-1258. Doi: http://dx.doi.org/1010.1016/S0140-6736(08)60559-0.
Sousa FGM, Erdmann AL, Mochel EG. Modelando a integralidade do cuidado à criança na Atenção Básica de Saúde. Rev Gaúcha Enferm. 2010; 31(4):701-07. Doi: http://dx.doi.org/10.1590/S1983-14472010000400013.
Pierantoni CR. As reformas do Estado, da saúde e recursos humanos: limites e possibilidades. Cienc Saúde Coletiva. 2001; 6(2):341-360. Doi: http://dx.doi.org/10.1590/S1413-81232001000200006.
Gupta N, Maliqi B, Franca A, Nyonator F, Pate M, Sanders D, et al. Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes. Hum Resour Health. 2011; 9(1): 16. Doi: http://dx.doi.org/10.1186/1478-4491-9-16.
Vianna SM, Nunes A, Santos JRS, Barata RB. Medindo a desigualdade em saúde no Brasil: uma proposta de monitoramento. OPS/IPEA; 2001.
Nascimento APS, Santos LF, Carnut L. Atenção primária à saúde via estratégia saúde da família no Sistema Único de Saúde: introdução aos problemas inerentes à operacionalização de suas ações. J Manag Prim Health Care. 2011; 2(1): 18-24.
Rosskam E, Pariyo G, Hounton S, Aiga H. Increasing skilled birth attendance through midwifery workforce management. Int J Health Plann Manage. 2013; 28(1): e62–e71. DOI: 10.1002/hpm.2131
Rosskam E, Pariyo G, Hounton S, Aiga H. Increasing skilled birth attendance through midwifery workforce management. Int J Health Plan. Mgmt. 2013; 28: e62–e71. DOI: 10.1002/hpm.2131
Domingues RMSM, Hartz ZMA, Dias MAB, Leal MC. Avaliação da adequação da assistência prénatal na rede SUS do Município do Rio de Janeiro, Brasil. Cad Saúde Pública. 2012; 28(3): 425-37. Doi: http://dx.doi.org/10.1590/S0102-311X2012000300003.
Uchimura LYT, Uchimura NS, Santana RG, Felchner PCZ, Uchimura TT. Adequabilidade da assistência ao pré-natal em duas unidades de saúde em Curitiba, Paraná. Cienc Cuid Saúde. 2014; 13(2): 219-27. Doi: http://dx.doi.org/10.4025/cienccuidsaude.v13i2.21256.
Atrash HK, Carpentier R. The evolving role of public health in the delivery health care. J Hum Growth Dev. 2012; 22(3): 396-399.
Wong ST, Lynam MJ, Khan KB, Scott L, Loock C. The social pediatrics initiative: A richer model of primary health care for children at risk and their families. BMC Pediatrics. 2012; 12: 158.Doi: http://dx.doi.org/10.1186/1471-2431-12-158.
Oliveira BRG, Viera CS, Collet N, Lima RAG. Acesso de primeiro contato na atenção primária em saúde para crianças. Rev RENE. 2012; 13(2): 332-42.
Bhutta ZA, Ali S, Cousens S, Ali TM, Haider BA, Rizvi A, et al. Interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make? Lancet. 2008; 372(9642):
-89.Doi: http://dx.doi.org/10.1016/S0140-6736(08)61407-5.
Ribeiro LCC, Rocha RL, Ramos-Jorge ML. Acolhimento às crianças na atenção primária à saúde: um estudo sobre a postura dos profissionais das equipes de saúde da família. Cad Saúde Pública. 2010; 26(12): 2316-2322. Doi: http://dx.doi.org/10.1590/S0102-311X2010001200010.
Costa GD, Cotta RMM, Reis JR, Siqueira-Batista R, Gomes AP, Franceschini SCC. Avaliação do cuidado à saúde da gestante no contexto do Programa Saúde da Família. Ciênc Saúde Coletiva. 2011; 14(5): 1347-57. Doi: http://
dx.doi.org/10.1590/S1413-81232009000800007.
Downloads
Publicado
Edição
Seção
Licença
CODE OF CONDUCT FOR JOURNAL PUBLISHERS
Publishers who are Committee on Publication Ethics members and who support COPE membership for journal editors should:
- Follow this code, and encourage the editors they work with to follow the COPE Code of Conduct for Journal Edi- tors (http://publicationethics.org/files/u2/New_Code.pdf)
- Ensure the editors and journals they work with are aware of what their membership of COPE provides and en- tails
- Provide reasonable practical support to editors so that they can follow the COPE Code of Conduct for Journal Editors (http://publicationethics.org/files/u2/New_Code.pdf_)
Publishers should:
- Define the relationship between publisher, editor and other parties in a contract
- Respect privacy (for example, for research participants, for authors, for peer reviewers)
- Protect intellectual property and copyright
- Foster editorial independence
Publishers should work with journal editors to:
- Set journal policies appropriately and aim to meet those policies, particularly with respect to:
– Editorial independence
– Research ethics, including confidentiality, consent, and the special requirements for human and animal research
– Authorship
– Transparency and integrity (for example, conflicts of interest, research funding, reporting standards
– Peer review and the role of the editorial team beyond that of the journal editor
– Appeals and complaints
- Communicate journal policies (for example, to authors, readers, peer reviewers)
- Review journal policies periodically, particularly with respect to new recommendations from the COPE
- Code of Conduct for Editors and the COPE Best Practice Guidelines
- Maintain the integrity of the academic record
- Assist the parties (for example, institutions, grant funders, governing bodies) responsible for the investigation of suspected research and publication misconduct and, where possible, facilitate in the resolution of these cases
- Publish corrections, clarifications, and retractions
- Publish content on a timely basis
