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Publication
O papel dos comitês de investigação da transmissão vertical da sífilis no brasil: potencialidades, vulnerabilidades e perspectivas culturais
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Abstract(s)
A transmissão vertical (TV) da sífilis representa um grave problema de saúde
pública, sobretudo para as populações mais vulneráveis com menores recursos
socioeconômicos e educacionais. Com a finalidade de reduzir a TV da sífilis e
alcançar a sua eliminação, o Ministério da Saúde do Brasil estabeleceu as
diretrizes para o funcionamento de comitês de investigação da transmissão
vertical (CITV) da sífilis como estratégicos para a prevenção da transmissão
vertical da sífilis (PTVS). Para melhor compreender as dinâmicas territoriais, a
organização, processos de trabalho, potencialidades e desafios dos territórios no
que diz respeito às agendas dos CITV da sífilis, esta pesquisa tem por objetivo
analisar o papel dos CITV da sífilis, no Brasil, para a PTVS.
Com este objetivo desenvolveu-se uma pesquisa exploratória e descritiva de
abordagem qualitativa do tipo estudo de caso em 25 Estados brasileiros e no
Distrito Federal. A recolha dos dados foi realizada por entrevistas, com suporte
de um questionário semiestruturado constituído por perguntas abertas e
fechadas, realizadas junto a informantes-chave de comitês e/ou espaços de
investigação da TV da sífilis. Os dados foram analisados no software Excel com
recurso à técnica de análise de conteúdo dividida em três fases: pré-análise,
exploração do material e tratamento dos dados e interpretação dos resultados.
Foi identificado que as organizações, processos de trabalho, dinâmicas,
potencialidades e vulnerabilidades dos espaços investigativos são múltiplos e
específicos em cada região e até entre os Estados. Mesmo assim, independente
da forma como estão organizados e de como é realizado o seu trabalho,
percebe-se que os espaços investigativos não têm cumprido o seu papel, muito
menos têm realizado a gestão dos casos e a integração intersetorial,
notoriamente entre atenção e vigilância. Esses fatos geram o questionamento
sobre o formato de ação, no modelo de comitê ou comissão definido pelo Brasil,
ser um caminho capaz de efetivamente incidir na PTVS e na redução do número
de casos no Brasil. Portanto, sugere-se rever a diretriz de modelo de agendas sistemáticas e
burocrático e refletir sobre novas ferramentas para análise de fatores e agravos
evitáveis pela sífilis, a partir da gestão dos casos automatizada, como exemplo
o Salus, um sistema proposto pelo Projeto Sífilis Não! capaz de unir dados de
vigilância e atenção, e apresentar painéis de indicadores e cenários locais que
facilitam a tomada de decisão do gestor no território de forma ágil e eficaz. Além
disso, sugere-se novos estudos que abordem como é realizada a gestão de
casos de sífilis em países que já eliminaram a TV, por exemplo, Cuba.
Vertical transmission (VT) of syphilis represents a serious public health problem, especially for the most vulnerable populations with lower socioeconomic and educational resources. In order to reduce syphilis VT and achieve its elimination, the Brazilian Ministry of Health established guidelines for the functioning of investigation committees on vertical transmission (CITV) of syphilis as strategic for the prevention of vertical transmission of syphilis (PTVS). To better understand the territorial dynamics, organization, work processes, potential and challenges of the territories with regard to the syphilis CITV agendas, this research aims to analyze the role of syphilis CITV in Brazil for PTVS. With this objective in mind, an exploratory and descriptive research with a qualitative approach of the case study type was developed in 25 Brazilian states and the Federal District. Data collection was carried out through interviews, supported by a semi-structured questionnaire consisting of open and closed questions, carried out with key informants of committees and/or spaces for investigating syphilis TV. Data were analyzed in Excel software using the content analysis technique divided into three phases: pre-analysis, material exploration and data processing and interpretation of results. It was found that the organizations, work processes, dynamics, strengths and weaknesses of investigative spaces are multiple and specific in each region and even between States. Even so, regardless of how they are organized and how their work is carried out, it is clear that investigative spaces have not fulfilled their role, much less have carried out case management and intersectoral integration, notably between care and surveillance. These facts raise questions about the format of action, in the committee or commission model defined by Brazil, being a path capable of effectively affecting PTVS and reducing the number of cases in Brazil. Therefore, it is suggested to review the systematic and bureaucratic agenda model guideline and reflect on new tools for the analysis of factors and diseases that can be avoided by syphilis, based on automated case management, such as Salus, a system proposed by the Non-Syphilis Project! capable of uniting surveillance and attention data, and presenting panels of indicators and local scenarios that facilitate the decision-making of the manager in the territory in an agile and effective way. In addition, new studies are suggested that address how syphilis cases are managed in countries that have already eliminated TV, for example, Cuba.
Vertical transmission (VT) of syphilis represents a serious public health problem, especially for the most vulnerable populations with lower socioeconomic and educational resources. In order to reduce syphilis VT and achieve its elimination, the Brazilian Ministry of Health established guidelines for the functioning of investigation committees on vertical transmission (CITV) of syphilis as strategic for the prevention of vertical transmission of syphilis (PTVS). To better understand the territorial dynamics, organization, work processes, potential and challenges of the territories with regard to the syphilis CITV agendas, this research aims to analyze the role of syphilis CITV in Brazil for PTVS. With this objective in mind, an exploratory and descriptive research with a qualitative approach of the case study type was developed in 25 Brazilian states and the Federal District. Data collection was carried out through interviews, supported by a semi-structured questionnaire consisting of open and closed questions, carried out with key informants of committees and/or spaces for investigating syphilis TV. Data were analyzed in Excel software using the content analysis technique divided into three phases: pre-analysis, material exploration and data processing and interpretation of results. It was found that the organizations, work processes, dynamics, strengths and weaknesses of investigative spaces are multiple and specific in each region and even between States. Even so, regardless of how they are organized and how their work is carried out, it is clear that investigative spaces have not fulfilled their role, much less have carried out case management and intersectoral integration, notably between care and surveillance. These facts raise questions about the format of action, in the committee or commission model defined by Brazil, being a path capable of effectively affecting PTVS and reducing the number of cases in Brazil. Therefore, it is suggested to review the systematic and bureaucratic agenda model guideline and reflect on new tools for the analysis of factors and diseases that can be avoided by syphilis, based on automated case management, such as Salus, a system proposed by the Non-Syphilis Project! capable of uniting surveillance and attention data, and presenting panels of indicators and local scenarios that facilitate the decision-making of the manager in the territory in an agile and effective way. In addition, new studies are suggested that address how syphilis cases are managed in countries that have already eliminated TV, for example, Cuba.
Description
Keywords
Doenças sexualmente transmissíveis Sífilis congênita Política de saúde Transmissão vertical de doença infecciosa Brasil Infectious disease transmission Vertical Syphilis Congenital Health policy
Pedagogical Context
Citation
Mareco, Thereza Cristina de Souza - O papel dos comitês de investigação da transmissão vertical da sífilis no brasil: potencialidades, vulnerabilidades e perspectivas culturais [Em linha]. [S.l.]: [s.n.], 2022. 320 p.