Abstract
ABSTRACT Objective: to analyze factors associated with the monitoring of actions to control cervical cancer in the Family Health Strategy, in a health region of northeastern Brazil. Method: a cross-sectional study conducted from January to March 2019 by means of interviews with 241 physicians and nurses from the Family Health Teams of the Vitória da Conquista health region, Bahia, Brazil. Adequate monitoring was assessed by the degree of actions taken to promote, prevent and actively seek to control cervical cancer. Three blocks of variables were tested as explanatory: professional characterization and training; organization of the unit and access to cytopathological exam; and care coordination and integration. Poisson regression with robust variance was employed, adopting hierarchical entry of variables. Results: 51.9% (95% CI: 45.5-58.2) of the professionals performed adequate monitoring for the control of cervical cancer. Being a nurse, working in the municipality’s primary care network (≥2 years), disclosure of results collection through posters and other communication means, existence of a high-grade lesion, time to perform the biopsy ≤1 month, and agility in the release of the reports were elements associated to the outcome. Conclusion: even with the extended coverage of the Family Health Strategy, small municipalities in the Northeast have characteristics that impose obstacles to comprehensiveness, favoring the incidence of high-grade lesions and greater difficulty in the control of cervical cancer. Assessing the assistance quality in this level revealed challenges in the regionalized network.
Highlights
Care for women’s health, from the perspective of cervical cancer (CC) control, requires assistance integration of health actions and services in Health Care Networks (HCNs) to guarantee access and resoluteness in an appropriate place and in a timely manner[1,2]
In the case of CC, in addition to recruitment and to the performance of the cytopathological examination, Primary Health Care (PHC) teams are responsible for referring women who need diagnostic confirmation and treatment of the precursor lesions to specialized care units, and longitudinal monitoring, even when the user is in other care levels[7]
51.9% of the professionals performed adequate monitoring of the CC control actions in the health region
Summary
Care for women’s health, from the perspective of cervical cancer (CC) control, requires assistance integration of health actions and services in Health Care Networks (HCNs) to guarantee access and resoluteness in an appropriate place and in a timely manner[1,2]. In the case of CC, in addition to recruitment and to the performance of the cytopathological examination, PHC teams are responsible for referring women who need diagnostic confirmation and treatment of the precursor lesions to specialized care units, and longitudinal monitoring, even when the user is in other care levels[7]. CC is an appropriate tracer condition to assess the quality of care provided in the HCN, as it mobilizes the health services in different points of care, in addition to being a long-term disease, with known and effective treatment[8]
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