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[2004年至2013年巴西欣古印第安人保护区的口腔卫生保健:基于评估指标的分析]

[Oral health care in the Xingu Indigenous Park, Brazil, from 2004 to 2013: an analysis based on evaluation indicators].

作者信息

Lemos Pablo Natanael, Rodrigues Douglas Antônio, Frazão Paulo, Hirooka Lucila Brandão, Guisilini Alana Cristina, Narvai Paulo Capel

机构信息

Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil.

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.

出版信息

Cad Saude Publica. 2018 Mar 29;34(4):e00079317. doi: 10.1590/0102-311X00079317.

Abstract

In 2011, the Brazilian National Oral Health Policy redefined its model of care for indigenous peoples, recommending the use of epidemiology and follow-up of the impact of activities using adequate indicators. The current study aimed to analyze trends in these indicators, proposed by the Brazilian Ministry of Health, in the Xingu Indigenous Park, Brazil, from 2004 to 2013. This was a quantitative study using secondary data from the Xingu Special Indigenous Health District and the Xingu Project of the Federal University of São Paulo. The coverage rate for first dental visit exceeded 60% in all the years analyzed except 2009 and 2010 (44.7% and 53.4%, respectively). The basic dental treatment indicator showed a significant increase, from 44.9% to 79.9%, between 2006 and 2008. The proportion of tooth extractions decreased from 24.3% in 2004 to 3.8% in 2011. Mean coverage of supervised collective toothbrushing showed the highest variation (1.2 to 23.3%). Access to oral health showed good coverage, and the indicator for completed treatment showed a higher percentage when compared to other indigenous peoples during the same period. Better performance on the tooth extractions indicator may have been due to the change in focus of care through partnerships with universities, although the indicators for supervised toothbrushing suggest the need to prioritize preventive measures. Changes in indigenous healthcare management, with weakening or absence of partnerships, may have negatively influenced the program's indicators.

摘要

2011年,巴西国家口腔健康政策重新定义了其针对原住民的护理模式,建议采用流行病学方法并使用适当指标对活动影响进行跟踪。本研究旨在分析2004年至2013年期间巴西卫生部提出的这些指标在巴西欣古印第安人保护区的变化趋势。这是一项定量研究,使用了欣古特殊印第安人健康区和圣保罗联邦大学欣古项目的二手数据。除2009年和2010年(分别为44.7%和53.4%)外,在所有分析年份中,首次牙科就诊的覆盖率均超过60%。2006年至2008年期间,基本牙科治疗指标显著提高,从44.9%升至79.9%。拔牙比例从2004年的24.3%降至2011年的3.8%。有监督的集体刷牙平均覆盖率变化最大(1.2%至23.3%)。口腔健康服务的可及性覆盖率良好,与同期其他原住民相比,完成治疗指标的百分比更高。拔牙指标表现更好可能是由于通过与大学合作改变了护理重点,尽管有监督刷牙指标表明需要优先采取预防措施。原住民医疗管理的变化,以及合作关系的削弱或缺失,可能对该项目的指标产生了负面影响。

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