Fernandes Noêmia Fernanda Santos, Galvão Jôse Ribas, Assis Marluce Maria Araújo, Almeida Patty Fidelis de, Santos Adriano Maia Dos
Universidade Federal da Bahia, Vitória da Conquista, Brasil.
Universidade Estadual de Feira de Santana, Feira de Santana, Brasil.
Cad Saude Publica. 2019 Oct 7;35(10):e00234618. doi: 10.1590/0102-311X00234618. eCollection 2019.
This article evaluates access to the Papanicolaou test in the Family Health Strategy (FHS) in municipalities in a health region. Cervical cancer control depends on a well-organized Family Health Strategy, so assessment of access to the Papanicolaou test reflects the quality of care at this level. This is a qualitative study with data produced in 10 focus groups, totaling 70 participants in four municipalities. We analyzed the organizational, symbolic, and technical dimensions of access to the Pap test, with cervical cancer control as the marker. The results indicate that living in rural areas was a barrier to access to the Papanicolaou test and exacerbated the inequalities. Nurses were the principal reference for access to the Pap test. The absence of necessary items for collecting cervical cytopathology specimens was a barrier to access in all the municipalities. There were obstacles to access for women with disabilities and lesbian women, with care that was fragmented and out of sync with individual characteristics. The numerous obstacles to access to the Papanicolaou test exposed the selectiveness of the Family Health Strategy in the health region, since it reproduced the invisibility of women with greater social vulnerability and exacerbated the existing inequalities.
本文评估了某卫生区域内各城市家庭健康战略（FHS）中帕潘icolaou检测的可及性。宫颈癌防控依赖于组织完善的家庭健康战略，因此对帕潘icolaou检测可及性的评估反映了该层面的医疗服务质量。这是一项定性研究，数据来自10个焦点小组，四个城市共有70名参与者。我们以宫颈癌防控为标志，分析了帕潘icolaou检测可及性的组织、象征和技术层面。结果表明，居住在农村地区是获得帕潘icolaou检测的障碍，并加剧了不平等。护士是获得帕潘icolaou检测的主要参考对象。所有城市都存在缺乏收集宫颈细胞病理学标本所需物品的问题，这是检测可及性的一个障碍。残疾妇女和女同性恋妇女在获得检测方面存在障碍，医疗服务零散，与个人特征不符。获得帕潘icolaou检测存在的诸多障碍暴露了该卫生区域家庭健康战略的选择性，因为它使社会脆弱性较高的妇女继续处于隐形状态，并加剧了现有的不平等。
