Avaliação da organização das ações de saúde sexual e reprodutiva em serviços de atenção primária de pequenos municípios da região de saúde Baixada Cuiabana – Mato Grosso

Abstract

Reproductive health care as a component of Brazilian public policies began with demographic interest linked to the context of family planning, without worrying about the quality of care practices, which was later incorporated into the scope of the Unified Health System (SUS). The guidelines for sexual and reproductive health care (SSR) became part of the scope of Primary Health Care (PHC) after the creation of the 2005 National Policy on Sexual and Reproductive Rights. Health, disease prevention, diagnosis, treatment, rehabilitation, harm reduction and health maintenance, extensive to SSR care. The development of evaluative actions at this level has been encouraged in the SUS. The objective of the study was to evaluate the performance of the PHC regarding the implementation of SSR actions in five small municipalities in the Baixada Cuiabana health region, in the state of Mato Grosso, in 2019. This is an evaluative research, with a quantitative approach and design cross-sectional, using the QualiAB System for Monitoring and Assessment of the Quality of Primary Care, specifically in the scope of attention to SSR. Sexual and reproductive health as a component dimension of QualiAB is evaluated in three domains: promotion of sexual and reproductive health, prevention and care for sexually transmitted infections, and care for reproductive health. The research was carried out in five small municipalities in the Baixada Cuiabana health region, continuing a similar study carried out in 2018, in the two largest municipalities in the same region, Cuiabá and Várzea Grande, in research under the same coordination and guidance. The PHC services of five small municipalities were evaluated, according to the IBGE classification (2010). Subdividing them into small sizes 1, 2, 3, 4 and 5, due to the significant differences in the population number of each one of them. The performance of municipalities in QualiAB presented a mean range between 0.87 and 1.24. The worst performance was found in the smallest municipality and the highest in the small municipality 3. As for SSR actions, there was a range of scores between 0.38 and 0.65. The ascending order of scores was equivalent to population sizes. The best set of actions evaluated in SSR stood out in Prevention and Assistance to STI/AIDS and Viral Hepatitis, while the worst set of actions for the five municipalities was found in relation to the actions of Promotion of Sexual and Reproductive Health. Throughout the study, each domain of SSR was assessed against its set of indicators. Therefore, comparing the scores obtained in the evaluations, it is possible to state that the development of SSR actions is proportional to the performance of the PHC. With the population groups divided by sizes, it was found that the larger the municipality, the better evaluated it is. Fact not associated with assistance coverage. It was also evidenced, a certain incipience in several sets of actions in SSR, which can promote changes, as well as improvements in the work process of the evaluated services.