Abstract
his study aimed to evaluate health professionals’ perception regarding the organization and functioning of the Tuberculosis Control Program in Foz do Iguacu, PR, Brazil. It is a qualitative study, in which the thematic axis was the structure and the centralization/decentralization of the control of tuberculosis. It was undertaken through open interviews, held in May 2009. Based on these, the empirical material was organized in the light of content analysis. The results revealed weakness in relation to the dimension of the physical structure and the human resources. Questions arose indicating Directly Observed Treatment as a paternalistic action. It was evidenced that there is a need for managers to take a position regarding the decentralization of tuberculosis control to Primary Health Care. However, the Central Thematic Unit revealed ambivalence relating to this theme. It is concluded that the Program, generally speaking, functions in line with the Ministry of Health’s recommendations.
Highlights
The year 2003 was a landmark for tuberculosis control in Brazil, as – in order to achieve the international goals of detecting 70% of the estimated bacillary cases and curing at least 85% of the diagnosed cases – the Ministry of Health added the control of the disease to the agenda of priorities for public policies(1).The World Health Organization indicated that in 2010, 6.2 million cases of tuberculosis were notified worldwide, totaling 5.4 million new cases, corresponding to 65% of the estimated cases
The health care covers five health districts, in which there are 28 Primary Healthcare Centers, 32 Family Health Teams, two Emergency Rooms, one municipal radiology clinic, one outpatient center dealing with specialities, one municipal public hospital, three private hospitals which provide services to the Unified Health System, one outpatient center specialized in HIV/AIDS, and another which is a center of excellence for the Ambivalence regarding tuberculosis control actions in primary health care treatment of tuberculosis(6)
The codification of the accounts resulted in the construction of two nuclei of meaning: “Inadequacies in the structure available for controlling tuberculosis”; and “The digression in the organization of the care for the person with tuberculosis”. These nuclei of meaning allowed the construction of a Central Thematic Unit: “Ambivalence in relation to the maintenance of the centralization of the care and the need to incorporate tuberculosis control actions in Primary Health Care”
Summary
The World Health Organization indicated that in 2010, 6.2 million cases of tuberculosis were notified worldwide, totaling 5.4 million new cases, corresponding to 65% of the estimated cases In this period, Brazil had a gross rate of incidence and mortality of 37.6 and 2.4 cases per 100,000 inhabitants respectively, improving in the ranking of the 22 countries which concentrate 82% of cases of tuberculosis worldwide; even so, the disease continues to be a challenge for the Unified Health System(2). With a view to ensuring the conclusion of treatment and the avoidance of multidrug resistance, in 1997, the component of Directly Observed Treatment was officially introduced in Brazil. This consists of the direct administration of the medication by a second person(1)
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