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[Pediatric care and associated factors in São Luís (Maranhão) Brasil]
A A da Silva1, U A Gomes, S R Tonial
1Universidade Federal do Maranhão, Departamento de Saúde Pública, São Luís, Maranhão, Brasil. aasilva@elo.com.br
Insights
Pediatric care coverage in São Luís reached 80%, but many children had fewer than the recommended checkups. Factors like more siblings and lower paternal education were linked to reduced pediatric care access.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Context:
- Pediatric care is crucial for early disease prevention in children.
- Optimal pediatric care involves at least nine checkups in the first year of life.
- Assessing pediatric care coverage and associated factors is essential for public health initiatives.
Purpose:
- To measure pediatric care coverage and identify associated factors among children in São Luís, Brazil.
- To analyze data from 290 children aged 1–23 months using a cross-sectional study design.
- To estimate adjusted relative risks using modified Cox regression for cross-sectional studies.
Summary:
- Pediatric care coverage in São Luís was 80%, with an average of 7.8 checkups in the first year.
- 44% of children had six or fewer checkups, falling short of the recommended nine.
- The Brazilian public health care system (Sistema Unico de Saúde, SUS) served 81% of children; 15% used health insurance.
- Increased siblings and lower paternal education (≤4 years) were associated with fewer checkups.
- Family income was not significantly associated with the number of checkups after adjustment.
Impact:
- Findings highlight a gap in recommended pediatric checkups for a significant portion of children in São Luís.
- Identifies specific socioeconomic factors (number of siblings, paternal education) associated with lower pediatric care utilization.
- Suggests educational and family planning programs as strategies to improve pediatric care coverage in the region.
Abstract:
Pediatric care is fundamental to preventing several diseases during the early years of childhood. Early medical care and having at least nine checkups in the first year of life are the ideal in pediatric care. It is essential to periodically assess whether or not these goals are being met. In 1994, a cross-sectional study was carried out using three-stage cluster sampling to measure coverage of pediatric care and factors associated with that care among children in the city of São Luís, in the state of Maranhão, Brazil. For data collection, a standardized questionnaire was used with the mother of the child or another person responsible for the child. The percentage of those refusing to participate or who were absent was 7%. This work analyzes data concerning 290 children between 1 and 23 months of age. The coverage estimates and 95% confidence intervals took into consideration possible effects of the study design. Cox's regression, modified for cross-sectional studies, was used to estimate adjusted relative risks. Pediatric care coverage for the population studied was 80%. The children had an average of 7.8 checkups in the first year; 44% of the children had six or fewer checkups during the first year of life, well below the recommended number. Eighty-one percent of the children were seen in the Brazilian public health care system (Sistema Unico de Saúde, SUS), and only 15% used health insurance. After adjusting for confounding factors, the factors "greater number of siblings at home" and "father with four or fewer years of schooling" were associated with not having checkups. After adjustment, family income was not associated with the number of checkups. Encouraging educational activities and perhaps also family planning programs are important strategies for increasing the coverage of pediatric care in the city of São Luís.