Biomedical subjects

V L Formigli

Publications and source records attributed to V L Formigli.

6 recordsLinked to original sources

PubMed2004

[The political and administrative context of the implementation of Health Districts in the State of Bahia, Brazil].

This investigation was conducted in order to determine the political and administrative context prevailing during the implementation of health districts in the state of Bahia, Brazil. The documentary review includes laws, agreements, and contracts at the State and Federal levels from 1987 to 1989. This period corresponded to the first phase of the State government after the 1986 elections. Information was also obtained from key informants and former directors of the State Secretariat of Health at the central level. We describe how the policy for regionalization by territory and population was formulated, and we review both State and national planning procedures, identifying the events leading to the decision to create health districts. We list the political instruments related to this decision and analyze the positions of the various actors in the Brazilian Health System in relation to this strategic choice. Brief comments are given about the difficulties faced by this proposal during the period studied.

English Abstract↗

PubMed2004

[Health evaluation: problems and perspectives].

This is a literature review of theoretical and methodological issues on health care evaluation of research and technical reports. Conceptual frameworks, approaches, subject matter, strategies, and study designs are identified and analyzed. Evaluative research designs are compared with epidemiological ones. A diverse terminology was encountered, and many methodological problems in the literature were examined. The incorporation of evaluative procedures in health planning or health policy-making and administration is still limited in Brazil, particularly at the local level. Recent implementation of projects for the reorganization of the health services system based on the administrative autonomy of Local Health Units raises the need for more appropriate strategies aimed at health care evaluation. Perspectives for the development of alternative strategies are indicated.

English Abstract↗

PubMed2003

[District allocation and utilization of health care services in Pau da Lima, Salvador, Bahia, Brazil].

This cross-sectional study is aimed at the identification of patterns in the utilization of health care services in Pau da Lima, a neighborhood in the city of Salvador, Bahia. In 1992, a household survey was carried out with 384 families selected through a random cluster sampling design. In each household, the family head or a surrogate informant was asked to answer a questionnaire about their use of any type of health care in the last month. From the total of 1,887 individuals, 236 reported at least one visit to health facilities during the referent period This means an estimated prevalence of health services utilization of 12.5%. With regard to the type of services, 25.9% of all visits were made to public sector facilities. Attendants were mainly women (73.7%) from 15 to 29 years of age. The main reason reported for the choice of the health facility was availability (63.7%), and the major reason for seeking health care was disease-related conditions (75.7%), rather than preventive procedures. These findings may result from the still unfinished process of distritalização(district allocation of services), which is evident in the lack of health services' infrastructure or coverage, as well as in persistent organizational problems. These issues may lead the population living in the respective district to seek health care outside the assigned catchment area. The authors discuss these findings in the context of the expansion of the private sector in the health area and the financial collapse of the public budget in Brazil.

English Abstract↗

PubMed2001

[Quality evaluation of health care service for adolescents].

OBJECTIVE: To evaluate the technical and scientific quality of care provided adolescents, pregnant adolescents and their offspring by the Emaús community's health service in Belém, state of Pará, Brazil, between 1994 and 1996. METHODS: Data for population and health care assessment were collected from medical records and compared with the PAHO/WHO and Brazilian Ministry of Health guidelines. RESULTS: The following features were satisfactory: anthropometric measurements and sexual maturity in adolescent health care program; visits scheduling, weight and blood pressure recording and proceedings in the event of medical problem in prenatal care; early registration in the health program, completing of the immunization schedule, weight and motor development recording and adequacy of medical visits in children care. Other aspects were less satisfactory, such as poor recording of clinical procedures and high level of inadequate or partially adequate procedures for the adolescent group; late admission to prenatal care and low recording of pregnant anti-tetanus immunization in prenatal care; high prevalence of early weaning and poor recording of children's height. CONCLUSION: This easy-to-perform assessment allowed to evaluate the quality of care provided and made it possible to reallocate services and medical procedures to offer health care service better organized and of better quality to meet the population needs.

Adolescent↗

PubMed1997

[Overestimate of vaccine coverage? New evidence from a survey in Pau da Lima].

To evaluate vaccination coverage in children 0 to 5 years of age, a cross-sectional study based on a household survey was carried out in 1992 in the Pau de Lima Health District, Salvador, Bahia, Brazil, using a cluster sampling technique. The district was subdivided into 30 small areas that were homogeneous with respect to socioeconomic characteristics. Information on the vaccination status of 385 children was obtained through verification of a vaccination card or campaign voucher, or, in the absence of these items, through verbal confirmation from the mother or other responsible person. Based on all the sources of information, the study found vaccination coverage rates in the entire age range of 69% for polio vaccine; 56% for DTP; 74% for measles vaccine; and 87% for BCG. These results suggest that rates obtained from routine records of the health services and vaccination campaigns may be overestimates. The authors discuss the implications of the low coverage rates found in the entire age group and especially among children under 1 year old.

BCG Vaccine↗

PubMedDate not supplied

[Evaluation of a comprehensive adolescent health care service].

The authors evaluate the Adolescent Health Clinic in the Emaús community in Belém, Pará, Brazil with regard to coverage, adequacy, accessibility, and utilization for the period 1994 to 1996. Coverage was calculated on the basis of clinical records and information collected from the target population. Adequacy was analyzed by comparing the service performance with goals established by PAHO/WHO for this kind of institution. Accessibility and utilization patterns were evaluated from information obtained by a population-based survey among adolescents living in the area. Results showed: a good degree of program adequacy vis-à-vis the final purpose, although some adjustments are needed, especially in human resources; lack of barriers to user access; reasonable coverage, despite the low proportion of consultations by adolescents; and utilization pattern compatible with the service provision profile, mainly directed towards curative and individual care. Recommendations are made to revise the hegemonic health care model to emphasize preventive, collective, and educational activities.

Adolescent↗