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      Saúde infantil em áreas pobres: resultados de um estudo de base populacional nos municípios de Caracol, Piauí, e Garrafão do Norte, Pará, Brasil Translated title: Child health in poor areas: findings from a population-based study in Caracol, Piauí, and Garrafão do Norte, Pará, Brazil

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          Abstract

          Este estudo teve por objetivo conhecer indicadores básicos de saúde infantil nos municípios de Caracol, Piauí, e Garrafão do Norte, Pará, Brasil. Mediante visitas domiciliares por amostragem sistemática, aplicaram-se questionários às mães de menores de cinco anos, investigando nível sócio-econômico, condições de habitação e saneamento da família, características demográficas, padrão de morbidade, de utilização de serviços de saúde e de assistência recebida durante a gestação e o parto. A análise consistiu da comparação de indicadores entre os dois municípios e foi avaliada através dos testes t e qui-quadrado. Das 1.728 crianças estudadas, 60% de suas famílias possuíam renda inferior a um salário mínimo mensal; 41% não contavam com qualquer tipo de sanitário; 10% de suas mães não realizaram uma única consulta de pré-natal; 30% nasceram no domicilio; 30% foram levadas à consulta médica nos últimos três meses; 20% apresentavam déficit > 2 desvios-padrão para o indicador altura/idade. Todos os indicadores estudados foram ruins em ambos os municípios, sobretudo em Garrafão do Norte. Aumentar a oferta de cuidados em saúde e melhorar as condições de habitação e saneamento deveriam ser prioridades nessas localidades.

          Translated abstract

          The aim of this study was to evaluate child health indicators in the municipalities (counties) of Caracol, Piauí State, and Garrafão do Norte, Pará State, Brazil. Through household visits using systematic sampling, previously trained interviewers applied a standard questionnaire to mothers of under-five children, investigating socioeconomic status, housing and environmental sanitation, demographic characteristics, disease patterns, and prenatal and childbirth care. The analysis used the t-test and chi-square test to compare indicators between the two municipalities. Of the 1,728 children studied, 60% were from families with incomes less than one monthly minimum wage (approximately U$200), 41% had no type of sewage treatment or disposal, 10% of mothers reported zero prenatal visits, 30% of the children were born in the same municipality, and 30% had been taken to a pediatric consultation in the previous 3 months; 20% had a height-for-age deficit > 2 standard deviations. All target indicators were deficient in both the municipalities (especially in Garrafão do Norte). Expanding health care supply and improving housing and sanitation conditions are priorities in both municipalities.

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          APPROPRIATE TECHNOLOGY FOR BIRTH

          (1985)
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            Consumer demand for caesarean sections in Brazil: informed decision making, patient choice, or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods.

            To investigate why some women prefer caesarean sections and how decisions to medicalise birthing are influenced by patients, doctors, and the sociomedical environment. Population based birth cohort study, using ethnographic and epidemiological methods. Epidemiological study: women living in the urban area of Pelotas, Brazil who gave birth in hospital during the study. Ethnographic study: subsample of 80 women selected at random from the birth cohort. Nineteen medical staff were interviewed. 5304 women who gave birth in any of the city's hospitals in 1993. Birth by caesarean section or vaginal delivery. In both samples women from families with higher incomes and higher levels of education had caesarean sections more often than other women. Many lower to middle class women sought caesarean sections to avoid what they considered poor quality care and medical neglect, resulting from social prejudice. These women used medicalised prenatal and birthing health care to increase their chance of acquiring a caesarean section, particularly if they had social power in the home. Both social power and women's behaviour towards seeking medicalised health care remained significantly associated with type of birth after controlling for family income and maternal education. Fear of substandard care is behind many poor women's preferences for a caesarean section. Variables pertaining to women's role in the process of redefining and negotiating medical risks were much stronger correlates of caesarean section rates than income or education. The unequal distribution of medical technology has altered concepts of good and normal birthing. Arguments supporting interventionist birthing for all on the basis of equal access to health care must be reviewed.
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              Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study.

              To determine whether breast feeding protects infants against pneumonia and whether the protection varies with age. Nested case-control study. Pelotas, southern Brazil. Cases were 152 infants aged 28-364 days who had been admitted to hospital for pneumonia. Controls were 2391 cases in a population based case-control study. Odds ratio of admission for pneumonia according to type of milk consumed (breast milk alone, breast and formula milk, or formula milk and other fluids only), use of fluid supplements apart from formula milk, and use of solid supplements. Infants who were not being breast fed were 17 times more likely than those being breast fed without formula milk to be admitted to hospital for pneumonia (95% confidence interval 7.7 to 36.0). This relative risk was 61 (19.0 to 195.5) for children under 3 months old, decreasing to 10 (2.8 to 36. 2) thereafter. Supplementation with solids was associated with a relative risk of 13.4 (7.6 to 23.5) for all infants and 175 (21.8 to 1405.1) for those under 3 months old. Breast feeding protects young children against pneumonia, especially in the first months of life. These results may be used for targeting intervention campaigns at the most vulnerable age groups.
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                Author and article information

                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro, RJ, Brazil )
                0102-311X
                1678-4464
                April 2009
                : 25
                : 4
                : 809-818
                Affiliations
                [02] Pelotas orgnameUniversidade Federal de Pelotas orgdiv1Programa de Pós-graduação em Epidemiologia Brazil
                [05] Curitiba orgnameCoordenação Nacional da Pastoral da Criança Brasil
                [01] Rio Grande orgnameUniversidade Federal do Rio Grande orgdiv1Faculdade de Medicina Brazil
                [04] Paulo Afonso orgnamePrefeitura Municipal de Paulo Afonso orgdiv1Secretaria de Assistência Social Brasil
                [03] Pelotas orgnameUniversidade Federal de Pelotas orgdiv1Departamento de Medicina Social Brazil
                Article
                S0102-311X2009000400012 S0102-311X(09)02500412
                10.1590/S0102-311X2009000400012
                19347207
                6c00b34e-a808-4a9b-b73b-60eb24d07248

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 04 July 2008
                : 11 November 2008
                : 08 December 2008
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 10
                Product

                SciELO Public Health

                Self URI: Texto completo somente em PDF (PT)
                Categories
                Artigo

                Health Status Indicators,Bem-Estar da Criança,Child Welfare,Indicadores Básicos de Saúde,Maternal-Child Health Services,Serviços de Saúde Materno-Infantil

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