Implicações de profissionais de saúde no processo de vacinação em duas unidades básicas de Belo Horizonte
| Ano de defesa: | 2012 |
|---|---|
| Autor(a) principal: | |
| Orientador(a): | |
| Banca de defesa: | |
| Tipo de documento: | Dissertação |
| Tipo de acesso: | Acesso aberto |
| Idioma: | por |
| Instituição de defesa: |
Universidade Federal de Minas Gerais
UFMG |
| Programa de Pós-Graduação: |
Não Informado pela instituição
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| Departamento: |
Não Informado pela instituição
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| País: |
Não Informado pela instituição
|
| Palavras-chave em Português: | |
| Link de acesso: | http://hdl.handle.net/1843/BUOS-9E3JLQ |
Resumo: | Objective: Evaluating the process of vaccination in two Basic Health Units (UBS) in the city of Belo Horizonte, Minas Gerais, discussing the implication of health professionals in this process, using the vaccination coverage against hepatitis b as a guide. As the structuring of work in a scientific article the specific objectives were: to understand the implication of professionals in the following activities in the process of vaccination in two of the UBS city of Belo Horizonte: professionals' performance during the consultations, active search, monitoring of vaccination coverage, identify representations professionals on: immunization activities conducted in UBS, childhood vaccination schedule, vaccine against hepatitis B and modes of action of parents and caretakers/guardians know the modes of involvement of professionals in the process of vaccination and vaccination coverage in the area of the Unit Basic Health (Article 1).Methods: It is a qualitative study, using notions of social representations theory and method of Structural Analysis of Narrative to carry out the interviews. The first phase of field work was to determine the health district and select the UBS, which was developed in the collection. Were chosen, two UBS located in the city of Belo Horizonte. For this was used the same criterion to define the instance corresponding to the regional and local coverage below recommended by PNI to control hepatitis B (95%), and time series analysis on the coverage of their services. The health district entitled A, as well as two selected UBS, titled 1 and 2, had the lowest vaccine coverage against hepatitis B in 2010. We interviewed all managers, doctors and nurses from both UBS, except those who were on sick leave, vacation or refused to participate, and the responsible for the vaccination room at each UBS, following a recommendation from the unit manager. Data collection was guided by a script with indirect questions about the vaccine against hepatitis B, vaccination coverage and vaccine card use and requesting professionals to talk about the situation in their service and what they thought about these activities. The interviews were recorded on audio recorder, transcribed verbatim and interpreted using the Structural Analysis of Narrative in three steps: Vertical Reading, Horizontal Reading and Cross Reading.Results: We interviewed 26 health professionals, including twenty (77%) nurses and general practitioners are members of ESF: Twelve (46%) and eight (32%), respectively. The other professionals are nurses support (2), nursing technicians (2) and pediatricians (4), which represent, respectively, 8% for each category of nursing and 16% for pediatricians. In analyzing the interviews, it was found that health professionals have representations that can be grouped into four categories related to the vaccination process and other aspects involved in it: 1) individual monitoring of vaccination: vaccination card, 2) monitoring of collective vaccination: vaccination coverage, 3) reflection on the low vaccine coverage against hepatitis b and 4) the importance of hepatitis B vaccine and vaccination schedule. In the first category, the monitor appears in narrative as an activity carried out within their departments, however, the analysis of the speeches explicit disjunctions, with assertions that deny this practice. In addition, the use of vaccination card information as a tool for the job is not a majority, so the active search strategy acquired a representation of some important health surveillance. In the second category, it is observed that the monitoring of vaccination coverage, as well as the flow of information about such value is so deficient in UBS. This provides the lack of professionals on the low vaccine coverage by UBS in which they work. The third category, which addresses the possible causes of low vaccination coverage against hepatitis B, the professionals had different opinions, citing, among others, lack of information and guidance or neglect of mothers; social problems; scheme extended. The representations of the respondents on the importance of the vaccine against hepatitis B, the fourth category studied, are based on scientific information and avoidable illness related to the future, without, however, refer to the transmissibility of the virus and the consequent importance to health conference.Conclusions: The evaluation of the vaccination of UBS pointed out flaws in the monitoring activities of the vaccination card, orientation of the parents / active search and monitoring of vaccination coverage. There are differences in the work process in relation to the practice of monitoring the vaccination card; fragmented observation favors the loss of opportunity for vaccination and the accumulation of susceptible community. The orientation of the parents / guardians who attend the UBS study does not present such a finding consistent with the discourse of professional and does not diminish the ignorance and fear of parents / guardians in relation to an activity that depends on their consent to be performed. The search activity as a strategy undervalued by professionals creates gaps in what should be a collection system for missing vaccination, and discourages professional completing the card mirror, since these are rarely used. The absence of monitoring VC in UBS favors ignorance of professionals about the vaccination status of children and hampers planning of health actions. Encourage and educate health professionals on the information generated in the vaccination room and the ACS, and the possibilities of their use are necessary actions to change the representations that contribute to failures in the process. In addition, strategies for monitoring all children in the catchment area can be strengthened beyond those existing at the private clinics. Overall, the results showed that the health professionals of UBS studied with regard to vaccination, with offices perform their core activities focused on the health of the individual to the detriment of public health. However, despite the faults mentioned in the process of vaccination of those units, we can consider that the involvement of health professionals is obviously exists, but lacks reformulations of both themselves and the organization and management of the work process, more investment in relation to monitoring and updating of children's immunization cards. |