de Oliveira Luisa Gonçalves Dutra, Natal Sonia, Camacho Luiz Antonio Bastos
Departamento de Planejamento em Saúde, Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, RJ, BR.
Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, SC, BR.
Rev Saude Publica. 2015;49:66. doi: 10.1590/S0034-8910.2015049005802. Epub 2015 Oct 9.
OBJECTIVE To analyze the influence from context characteristics in the control of tuberculosis in prisons, and the influence from the program implementation degrees in observed effects.METHODS A multiple case study, with a qualitative approach, conducted in the prison systems of two Brazilian states in 2011 and 2012. Two prisons were analyzed in each state, and a prison hospital was analyzed in one of them. The data were submitted to a content analysis, which was based on external, political-organizational, implementation, and effect dimensions. Contextual factors and the ones in the program organization were correlated. The independent variable was the program implementation degree and the dependent one, the effects from the Tuberculosis Control Program in prisons.RESULTS The context with the highest sociodemographic vulnerability, the highest incidence rate of tuberculosis, and the smallest amount of available resources were associated with the low implementation degree of the program. The results from tuberculosis treatment in the prison system were better where the program had already been partially implemented than in the case with low implementation degree in both cases.CONCLUSIONS The implementation degree and its contexts - external and political-organizational dimensions - simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons.
目的 分析监狱结核病防控中环境特征的影响，以及项目实施程度对观察效果的影响。方法 采用多案例研究和定性研究方法，于2011年和2012年在巴西两个州的监狱系统开展研究。每个州分析两所监狱，其中一所监狱的监狱医院也纳入分析。数据采用基于外部、政治组织、实施和效果维度的内容分析法进行分析。将环境因素与项目组织中的因素进行关联分析。自变量为项目实施程度，因变量为监狱结核病防控项目的效果。结果 社会人口脆弱性最高、结核病发病率最高且可用资源最少的环境与项目实施程度低相关。在项目已部分实施的监狱系统中，结核病治疗效果优于项目实施程度低的情况。结论 项目实施程度及其环境——外部和政治组织维度——共同影响所分析监狱中结核病防控的观察效果。
