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Children's health care in the care network for people with disabilities in Brazil: a multicenter study
Ayrles Silva Gonçalves Barbosa Mendonça1, Bianca Larissa Lesca de Oliveira1, Tiótrefis Gomes Fernandes1
1Universidade Federal do Amazonas. Av. General Rodrigo Octavio Jordão Ramos 1200, Coroado I. 69067-005 Manaus AM Brasil. ayrles@ufam.edu.br.
Insights
Primary health care teams that are part of family health strategies significantly improve early identification and developmental follow-up for children with disabilities. Knowledge of the Care Network for People with Disabilities (RCPCD) is also crucial.
Area of Science:
- Public Health
- Pediatrics
- Healthcare Management
Background:
- Early identification and consistent developmental follow-up are critical for children with disabilities to ensure optimal outcomes.
- Primary Health Care (PHC) services play a vital role in delivering these essential services.
- The Care Network for People with Disabilities (RCPCD) aims to standardize and improve care for this population.
Purpose of the Study:
- To identify factors associated with the early identification of disabilities in children within PHC settings.
- To determine factors linked to the provision of developmental follow-up for children with disabilities in PHC.
- To evaluate the impact of different PHC models and professional knowledge on these services under the RCPCD.
Main Methods:
- A cross-sectional study was conducted using data from a multicenter study across eight states.
- Data were collected via structured questionnaires administered to degree-qualified PHC professionals, selected through random sampling stratified by state and municipality.
- Poisson regression with robust variance was employed to analyze associations with early identification and developmental follow-up.
Main Results:
- Among 1,488 professionals, 63.6% reported performing early identification of disabilities, and 49% provided developmental follow-up.
- Family health teams demonstrated higher rates of both early identification and developmental follow-up compared to traditional PHC models.
- Expanded family health teams showed superior performance in developmental follow-up compared to both traditional and standard family health teams.
- Profession, working within a family health team, and knowledge of the RCPCD were strongly associated with improved identification and follow-up.
Conclusions:
- Family health teams, particularly expanded models, are more effective in delivering early identification and developmental follow-up services for children with disabilities within PHC.
- Professional characteristics, team structure (family health teams), and specific knowledge (RCPCD) are key determinants for enhancing these critical services.
- Strengthening PHC through integrated team approaches and targeted knowledge dissemination is essential for improving care for children with disabilities.
Abstract:
The aim of this study was to identify factors associated with early identification of disabilities and developmental follow-up of children in primary health care (PHC) services under the Care Network for People with Disabilities (RCPCD). We conducted a cross-sectional study using data from a multicenter study undertaken in eight states. The data were collected using a structured questionnaire answered by PHC professionals with degree-level qualifications selected using random sampling and stratified by state and municipality. Poisson regression with robust variance was performed for the two outcomes. Of the 1,488 workers in the final sample, 63.6% performed early identification of disabilities and 49% provided developmental follow-up. Family health teams performed early identification of disabilities and follow-up more than traditional model teams, and expanded family health teams provided developmental follow-up more than both these teams. The factors that showed the strongest association with identification and developmental follow-up were profession, working in a family health team and knowledge of the RCPCD.
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