Abstract
ABSTRACT Objective to investigate the follow-up and characteristics of children and youth with special healthcare needs within Primary Health Care services located in a city in the State of São Paulo, Brazil. Method this qualitative study was supported by the Primary Health Care framework, and interviews were held with 37 health workers from the primary health care units located in the interior of São Paulo. Data were collected from May to December 2018 and treated with inductive thematic analysis. Results from the perspective of the health workers, the characteristics of these children and youth are centered on the dependence of specific care such as to promote psychomotor development, and dependence on technology and pharmacological treatments. They reported the difficulty to access health services while the primary health care services do not implement systematic follow-up. Conclusion these children and youth demand continuous and longitudinal care, which, however, is not provided by primary health care services, considering the discontinuity of care and a lack of networked follow-up. Therefore, health services need to be reorganized to keep up with changes in the child and youth morbidity and mortality to ensure continuous, integral, and networked follow-up to this population.
Highlights
The literature has recently reported changes in the morbidity and mortality rates of children and youth in Brazil
Thirty-seven health workers from three Family Health Strategy units and two Primary Care units participated in this study: 13 community health agents, six nursing one general practitioner, three dentists, six nurses, one pharmacist, three family physicians, one nutritionist, and three pediatricians aged 45.8 years old on average; 29 women and eight men
The results show that the main characteristic of these children and youth with special healthcare needs is their dependence on specific care, though some participants mentioned having a medical diagnosis of a chronic condition to be the main defining factor
Summary
The literature has recently reported changes in the morbidity and mortality rates of children and youth in Brazil. These changes are caused by a set of factors such as a decreased number of infectious diseases, improved basic sanitation, greater access to health services, and preventive measures to fight child mortality. May be accompanied by some degree of dependency throughout life.[1] This vast and heterogeneous group of chronic conditions[2] comprises a subgroup called Children with Special Health Care Needs (CSHCN). This group has one aspect in common, the need for continuous and long-term healthcare, educational or social assistance of a type or amount beyond that required by children at the same age.[3]
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