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[流感疫苗接种范围内初级卫生保健的可及性和质量的差异方面]

[Differential aspects in the access to and quality of primary health care within the scope of the vaccine coverage for influenza].

作者信息

Holanda Wanessa Tenório Gonçalves, Oliveira Silvano Barbosa de, Sanchez Mauro Niskier

机构信息

Programa de Pós-graduação em Medicina Tropical, Universidade de Brasília. Campus Universitário Darcy Ribeiro, 70910-900. Brasília DF Brasil.

Organização Panamericana de Saúde. Brasília DF Brasil.

出版信息

Cien Saude Colet. 2022 Apr;27(4):1679-1694. doi: 10.1590/1413-81232022274.03472021. Epub 2021 Jun 17.

DOI:10.1590/1413-81232022274.03472021
PMID:35475845
Abstract

A drop in the percentages of vaccination coverage in Brazil has been detected in a scenario where there is progressive growth in the coverage of Primary Health Care (PHC), namely the location where most of the vaccination actions occur. This article investigated the differences in PHC access and quality profiles among municipalities that attained or failed to attain coverage targets for influenza in 2019, stratified by vaccination priority groups. In this ecological study, we compared predictors of reaching the goal of vaccination coverage for influenza, considering access, quality, and characteristics of the municipality. For all groups, the set of municipalities that reached the targets had greater PHC and Family Health Strategy coverage and a greater number of Community Health Agents per thousand inhabitants. They also carried out more active searches for children with delayed vaccination schedules, registered the vaccination of pregnant women on the same day, had unit opening hours that met user expectations, showed greater user satisfaction with the care received and had a higher percentage of the population with access to garbage collection. The variables may support decision-making about the organization of PHC services with the purpose of expanding vaccine coverage for influenza.

摘要

在初级卫生保健(PHC)覆盖率逐步增长的情况下,巴西检测到疫苗接种覆盖率百分比有所下降,而初级卫生保健正是大多数疫苗接种行动开展的场所。本文按疫苗接种优先群体分层,调查了2019年达到或未达到流感疫苗接种覆盖率目标的各市在初级卫生保健可及性和质量概况方面的差异。在这项生态学研究中,我们考虑了各市的可及性、质量和特征,比较了实现流感疫苗接种覆盖率目标的预测因素。对于所有群体而言,达到目标的各市组初级卫生保健和家庭健康战略覆盖率更高,每千名居民拥有的社区卫生工作者数量更多。它们还更积极地查找疫苗接种延迟儿童,在同一天登记孕妇的疫苗接种情况,单位开放时间符合用户期望,用户对所接受的护理满意度更高,并且有更高比例的人口能够获得垃圾收集服务。这些变量可能有助于为初级卫生保健服务的组织提供决策依据,以扩大流感疫苗接种覆盖率。

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