RESUMO
OBJECTIVE: To evaluate the implementation of its participative strategies and the creation of support networks for poor pregnant women. MATERIAL AND METHODS: A qualitative and comparative evaluation was carried on in four states. RESULTS: Coordination and community participation were relevant in relation with major resources allocation and availability, particularly housing and transportation. Governmental actors involvement and leadership favoured linking and coordination. Pregnant women used to valuate as the major support source the one provided by their kinship networks. CONCLUSIONS: To strengthen and to stimulate participative strategies is fundamental in zones with high maternal mortality rates. The wide appreciation of kinship networks, midwives and voluntaries' support to pregnant women in housing and transportation, suggests that these actors are a functional component of the support network; it is insufficient focusing the support network on health services and municipal authorities.
Assuntos
Redes Comunitárias/organização & administração , Serviços de Saúde Materna/organização & administração , Adulto , Participação da Comunidade , Estudos Transversais , Feminino , Política de Saúde , Recursos em Saúde , Necessidades e Demandas de Serviços de Saúde , Habitação , Humanos , Serviços de Saúde Materna/estatística & dados numéricos , México , Tocologia , Pobreza , Gravidez , Avaliação de Programas e Projetos de Saúde , Apoio Social , Meios de Transporte , VoluntáriosRESUMO
OBJETIVO: Evaluar la implementación de las medidas participativas y la conformación de redes de apoyo para mujeres embarazadas. MATERIAL Y MÉTODOS: Se realizó una evaluación cualitativa y comparativa en cuatro estados. RESULTADOS: La coordinación y la participación comunitaria fueron favorables en los casos en los que se observó mayor asignación y disponibilidad de recursos, tales como transporte y posadas maternas. La participación y el liderazgo de actores gubernamentales favorecieron la vinculación y coordinación. El apoyo más valorado por las usuarias provino de su red de parentesco. CONCLUSIONES: Es fundamental fortalecer y promover medidas participativas en zonas con elevada mortalidad materna. La amplia valoración de las redes de parentesco, las parteras y el voluntariado en los albergues sugiere que estos actores son un componente funcional de la red de apoyo y que es insuficiente focalizar la red en los servicios de salud y las autoridades municipales.
OBJECTIVE: To evaluate the implementation of its participative strategies and the creation of support networks for poor pregnant women. MATERIAL AND METHODS: A qualitative and comparative evaluation was carried on in four states. RESULTS: Coordination and community participation were relevant in relation with major resources allocation and availability, particularly housing and transportation. Governmental actors involvement and leadership favoured linking and coordination. Pregnant women used to valuate as the major support source the one provided by their kinship networks. CONCLUSIONS: To strengthen and to stimulate participative strategies is fundamental in zones with high maternal mortality rates. The wide appreciation of kinship networks, midwives and voluntaries' support to pregnant women in housing and transportation, suggests that these actors are a functional component of the support network; it is insufficient focusing the support network on health services and municipal authorities.
Assuntos
Adulto , Feminino , Humanos , Gravidez , Redes Comunitárias/organização & administração , Serviços de Saúde Materna/organização & administração , Participação da Comunidade , Estudos Transversais , Política de Saúde , Recursos em Saúde , Necessidades e Demandas de Serviços de Saúde , Habitação , Serviços de Saúde Materna/estatística & dados numéricos , México , Tocologia , Pobreza , Avaliação de Programas e Projetos de Saúde , Apoio Social , Meios de Transporte , VoluntáriosRESUMO
Objetivo. Analizar la utilización de las unidades de atención primaria a la salud (UAPS) por pacientes febriles en áreas de transmisión de paludismo, en diferentes condiciones de organización de los servicios de salud. Material y métodos. Estudio transversal realizado en septiembre de 1993, en 32 localidades de los estados de Tabasco (con servicios de salud descetralizados) y Campeche ( no descentralizados). Se efectuó un análisis descriptivo y se identificaron variables predictoras de utilización de las UAPS mediante una regresión logística. Resultados. Se entrevistaron 817 febriles, de los cuales 55 por ciento se atendieron en casa; 16.4 por ciento utilizaron UAPS y 17 por ciento fueron atendidos por colaboradores voluntarios, sin diferencias entre ambos estados. Los febriles de localidades con UAPS las utilizaron 11 veces más (IC 95 por ciento 7.0-18.2) que aquéllos sin UAPS; los graves 2.8 veces más (IC 95 por ciento 1.7-4.6) que los leves-moderados y los <13 años (IC 95 por ciento 1.3-2.9) 1.9 veces más que los ò13 años. Sólo 2 por ciento de los febriles fueron casos de paludismo. Conclusiones. No hubo diferencias en la utilización de UAPS entre estado descentralizado y no descentralizado. Debe revalorarse la fiebre como indicador único para detección de paludismo
Objective. To analyze primary health care service (PHCS) utilization by febrile patients in a malarial area of Mexico. Material and Methods. A cross-sectional study was carried out in September, 1993, in 32 communities of Tabasco (decentralized health services) and Campeche (non-decentralized) states. Predictors of utilization were analyzed using descriptive statistics and logistic regression analysis. Results. 817 febrile patients were interviewed, 55% of all febrile patients received care at home (SELF), 16.5% by PHCS and 17% by volunteer collaborators, with no significant differences in health services utilization between states. Febrile patients living in communities where PHCS was available used these facilities 11 times more than those without PHCS (C.I. 95%: 7.0-18.2%). Severely febrile patients used PHCS 2.8 times more than mild-moderate cases (C.I. 95%: 1.7-4.6%). Febrile patients under 13 years of age used PHCS 1.9 times more than older patients. Two per cent of febrile patients consisted of malaria cases. Conclusions. There was no difference between decentralized and non-decentralized health services regarding the utilization of PHCS. Fever symptoms must be evaluated as a single screening indicator of malarial disease.