Avaliação da organização e do desempenho dos serviços de atenção primária no controle da tuberculose em Feira de Santana-BA, 2007

Abstract

Tuberculosis (TB), a potentially curable and preventable disease, still represents a large problem in public health in developing countries, reaching the state of neglected calamity. The present study had as goal to evaluate the organization and performance of the services in primary care, related to range of services and coordination, in the control of tuberculosis in the municipality of Feira de Santana. By means of an epidemiological study with the model of inquiry of service evaluation. 2 groups participated in this study: 100 patients and 14 professionals, both with deliberate samples. For the handling of the data a data bank was created in the software Statistica 6.1 that includes frequency of analysis and test X2 of association among the items of the questionnaire. The level of significance was of 5 %. The results of the frequency analysis showed that for 98 % of the patients the supervised treatment had never been offered; for 50 % of the patients the HIV test had never been offered; 52 % had never received a house call during tuberculosis treatment. The items of the questionnaire that show major statistical association were: patients that always received basic food allowance are more frequent among those that always received transportation voucher (91.30%) and less frequent in patients that never received a transportation voucher (25.97%). The study showed that the tuberculosis control actions in the municipality are still centralized in an ambulatory care clinic of reference with an insufficient system of reference and conter reference. In the majority of the variables, the data reveal divergences in the patient’s perspective regarding the professional, demonstrating the fragility of the care in the tuberculosis control program, whose policies are well defined and with the best evaluations being performed by the professionals and the worst ones by the patients. Thus, the necessity of integration of the actions in the control of tuberculosis, inserted in a system organized in its various levels of care with the interaction of different actors involved. The patients of Tuberculosis in the municipality do not count on a decentralized network of services. The actions of the control of the disease are done at the unit of reference. The supervised treatment is not offered. It can be noted that only the basic activities of the program, such as the monthly consultations, are guaranteed. Emphasized is the necessity of actual steps to be taken for the implementation of control actions with the involvement of all the segments (managers, health workers and users of the system).