Ciencia & saude coletiva最新文献

We investigated the timely initiation of antenatal care among Brazilian adolescents to support the national discussion on the gestational age limit for legal abortion. Using data from the Live Births Information System (SINASC) 2020-2022, we correlated the timely antenatal care (first quarter of pregnancy) with the adolescent's age, region, ethnicity/skin color, and schooling level; 11,607 annual births result from vulnerable rape. The timely initiation of antenatal care was 70.2% for all adolescents (<20 years), but only 55.6% for those under 13 years old; 14.1% of adolescents started antenatal care at 22 weeks or more of gestation (28.3% among those <13 years old). Timely initiation was lower in the North region, among Indigenous girls, and those with low education. Delays in recognizing the pregnancy and communicating with the family contribute to the late start of antenatal care and the decision to abort. The proposed legal abortion time limit will mainly impact the most vulnerable adolescents in terms of socioeconomic and racial factors.

The Ministry of Health recommends a minimum appointment schedule in childcare to monitor growth and development. The objective was to analyze the adequacy of the minimum appointment schedule for children under 5 years of age, with at least one anthropometric follow-up registered with the Food and Nutrition Surveillance System (SISVAN) between 2008 and 2020. The sample size comprised 23,453,620 children under the age of 5, and 103,773,311 records. The indicators analyzed were the average number of appointments and the adequacy of the last scheduled visit. In Brazil, the median number of appointments was three, which is lower than the recommended schedule. For children born after 2008, the adequacy of the last scheduled appointment was 11.8% with inequalities, lower in the North (5.7%) and higher in the South (22.5%). Comparing the federal units, Amapá and Roraima had the lowest frequencies, and Paraíba and Paraná the highest. The adequacy of the last scheduled appointment was higher among municipalities in the top fifth of GDP per capita. SISVAN reveals inequalities in access to health services; the highest level of adequacy with the minimum appointment schedule is in the South and Southeast regions.

This study aimed to evaluate the body composition of the Khisêdjê, an Indigenous people residing in the Xingu Indigenous Territory, and compare it to the results obtained by anthropometry. One hundred seventy-nine individuals aged above 20 of both genders were included. The nutritional status was classified per the cutoff proposed by the WHO (1995). The body composition was identified using measures derived directly from a bioelectrical impedance device (resistance - R, reactance - Xc, and phase angle - PA). Data were analyzed using the Student t-test, chi-square, Pearson correlation, and analysis of variance, and 57% of the sample was male. The mean age of the population was 37.5 years, and 48% of subjects had some overweight level (BMI ≥ 25,0 kg/m2). We identified a positive correlation between BMI with waist (WC) and arm (AC) circumference, and PA measurements, and an inverse correlation between BMI and R and Xc measurements. R and Xc mean values decreased with increasing BMI. In contrast, mean PA increased with greater weight. The results suggest that being overweight among the Khisêdjê Indigenous people was associated with higher muscle mass amounts.

The present article aimed to analyze the association between sociodemographic and hospitalization characteristics with the outcome of indigenous and non-indigenous pregnant and postpartum women, as well as factors associated with deaths among indigenous women hospitalized for Severe Acute Respiratory Syndrome (SARS) due to COVID-19 in Brazil. This is a cross-sectional and analytical study, with secondary data of pregnant and postpartum women of reproductive age, classified into race/skin color (indigenous and non-indigenous), extracted from the Obstetric Observatory, which uses data from the Influenza Epidemiological Surveillance Information System. The outcome variables were analyzed using the chi-square test or Fisher's exact test, and logistic regression was performed for the factors associated with the death of indigenous people. The highest proportion of deaths occurred among non-indigenous women who were in the 2nd trimester of pregnancy (99.7%), who lived in urban/peri-urban areas (99.8%), as well as in the South/Southeast (99.8%) and Northeast (99.5%) regions. Indigenous people who lived in rural areas and in the North and Midwest regions have a greater chance of death when compared to indigenous people who lived in urban areas and in the South/Southeast regions.

Epidemiological surveys by ethnic groups are scarce in Brazil. The health and nutrition conditions of indigenous peoples who face situations of social inequities and inequalities, negatively influence their health indicators. This study is the widest investigation on the subject ever carried out on the Baniwa ethnic group, one of the most numerous in the country. The survey aimed to analyze the living conditions and nutritional profile of children aged under 60 months and women aged 14 to 49 years of the Baniwa ethnic group, residing in the northwest region of the state of Amazonas, in the Indigenous Land of Alto Rio Negro, an area that serves as a border connecting Brazil, Colombia, and Venezuela. The results show a high prevalence of chronic malnutrition in 52.5% (95%CI 48.9-56.1) and anemia in 68.3% (95%CI 64-5-71.8) of children under 60 months, in addition to overweight in 26.3% (95%CI 18.4-27.0) and anemia in 52.3% (95%CI 43.6-53.6) of the women. The situations of food insecurity observed in this study are linked to poor income and sanitation conditions. The magnitude of these injuries expresses the low effectiveness of primary care actions offered by the health system, with a significant percentage of hospitalizations resulting from injuries sensitive to basic care at the primary care level.

This article discusses the meanings of differentiated health care guideline given by health professionals from the Indigenous Health Multidisciplinary Team (EMSI) who work at the Alto Rio Negro Special Indigenous Health District (DSEI-ARN). This exploratory, descriptive, analytical, and qualitative study conducted 15 semi-structured interviews with professionals from the Indigenous Health Multidisciplinary Teams of the DSEI-ARN, which were submitted to content analysis. The four meaning cores identified from the analyses were: Differentiated care as a way of providing primary care in the territory; Actions conducted under the population's cultural differences; Self-care, traditional medicine, and the construction of therapeutic itineraries; and Professionals' challenges and difficulties in addressing traditional indigenous health care. In the professionals' perspective, differentiated health care is linked to the conditions for working in this primary care type. For their performance, they refer to the need to respect the cultural differences of the Indigenous population. Professionals recognize the use and effectiveness of Indigenous practices, knowledge, and regional specificities.

This article analyzes the sociodemographic composition of the Indigenous population in Brazil in the 1991, 2000, and 2010 demographic censuses, in addition to investigating inequalities in access to basic sanitation and electricity based on the 2010 Census. A methodology is proposed that classifies households with Indigenous residents as "homogeneous", "mixed" with an Indigenous in the category "household head", and mixed with a non-Indigenous in the category "household head". Regional and situational differences overlapped with differences by type of household and location, with better conditions in urban than rural areas and in the Southeast and South. The North was the region with the least access in general. Regional differences and differences between urban/rural areas were observed, highlighting better urban conditions in the Southeast and South. These inequalities reflect fragmented public policies, economic pressures, and deterritorialization, among other factors. The development of new techniques and critical debate is essential to understanding and addressing racial inequalities in the country and promoting public policies appropriate to Indigenous peoples.

This ecological study conducted with secondary data extracted from the Indigenous Health Care Information System (SIASI) analyzed the access to oral health services provided to Xukuru do Ororubá Indigenous peoples from 2017 to 2018. The units of analysis were the Indigenous villages. The services delivered by the oral health teams working in the context were analyzed, verifying access and performance indicators and their parameters. The socioeconomic and demographic conditions, the provision of services, and the spatial components of the territory were characterized. The correlation coefficients between indicators were estimated. The results showed a growing coverage of first dental appointments, the mean number of procedures per capita, the percentage of tooth extractions, the coverage of supervised tooth brushing, and a decrease in the rate of completed treatments. There were better access opportunities for the Xukuru do Ororubá Indigenous people in the period analyzed. However, there is a persistent need to strengthen the continuity of services to complete treatments. The study points to the need for indicators suitable for the context of Indigenous health and the potential of the SIASI for oral health surveillance.

This study aimed to analyze the adaptation of prenatal care offered to Indigenous women and its association with maternal characteristics and health services. This is a cross-sectional study, conducted with 461 Indigenous women who gave birth and/or received immediate postpartum care in the municipalities of Mato Grosso do Sul, between 2021 and 2022. An indicator of minimum prenatal adequacy was developed, which was classified as adequate when the woman started prenatal care in the 1st trimester of pregnancy, had ≥7 consultations, and had routine exams recorded. Logistic regression models were used to estimate the adjusted odds ratios and factors associated with prenatal adequacy. It was found that 67.2% began prenatal care in the 1st trimester, 51.8% had ≥7 consultations, and 40.6% had exam results recorded. About 1 in 4 Indigenous women achieved the proposed adequacy; the associated maternal characteristics were ethnicity, region of residence, and place of residence. Prenatal care revealed health inequities, with low adequacy rates in prenatal care and worse rates among women living in villages and settlements in the southern region of the state.