TY - JOUR
T1 - Quality of cervical cancer screening in Brazil
T2 - external assessment of the PMAQ
AU - Barcelos, Mara Rejane Barroso
AU - de Cássia Duarte Lima, Rita
AU - Tomasi, Elaine
AU - Nunes, Bruno Pereira
AU - Duro, Suele Manjourany Silva
AU - Facchini, Luiz Augusto
N1 - Publisher Copyright:
© This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided that the original author and source are credited.
PY - 2017
Y1 - 2017
N2 - OBJECTIVE: To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening.METHODS: This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context), demographic characteristics (user profile), and two domains related to the organization of basic services (work structure and process). The low quality of the screening was assessed from the lack of access, late examination, and lack of guidance. Crude and adjusted analyses by Poisson regression assessed the association between outcomes and independent variables. RESULTS: The values of lack of access, late examination, and lack of guidance were 6.7%, 11.2%, and 19.2%, respectively. Problems of quality were lower according to the increase in Municipal Human Development Index and per capita household income, increasing with population size and municipal coverage of the Family Health Strategy. The Midwest region of the country presented the highest occurrences of low quality outcomes. Indigenous and yellow women had the highest prevalence of outcomes. Women with partner, who received the Bolsa Família Program, and who had paid work had less chances of having lack of access, late examination, and lack of guidance. The appropriate work process in health services decreased the likelihood of low quality in all indicators.CONCLUSIONS: Investments in the work process of health teams, social cash transfer programs, and social conditions of the population are essential to improve the quality of the program of cervical cancer screening in Brazil.
AB - OBJECTIVE: To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening.METHODS: This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context), demographic characteristics (user profile), and two domains related to the organization of basic services (work structure and process). The low quality of the screening was assessed from the lack of access, late examination, and lack of guidance. Crude and adjusted analyses by Poisson regression assessed the association between outcomes and independent variables. RESULTS: The values of lack of access, late examination, and lack of guidance were 6.7%, 11.2%, and 19.2%, respectively. Problems of quality were lower according to the increase in Municipal Human Development Index and per capita household income, increasing with population size and municipal coverage of the Family Health Strategy. The Midwest region of the country presented the highest occurrences of low quality outcomes. Indigenous and yellow women had the highest prevalence of outcomes. Women with partner, who received the Bolsa Família Program, and who had paid work had less chances of having lack of access, late examination, and lack of guidance. The appropriate work process in health services decreased the likelihood of low quality in all indicators.CONCLUSIONS: Investments in the work process of health teams, social cash transfer programs, and social conditions of the population are essential to improve the quality of the program of cervical cancer screening in Brazil.
KW - Diagnosis
KW - Program evaluation
KW - Socioeconomic factors
KW - Uterine cervical neoplasms
KW - Women’s health services
UR - http://www.scopus.com/inward/record.url?scp=85029668054&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029668054&partnerID=8YFLogxK
U2 - 10.1590/S1518-8787.2017051006802
DO - 10.1590/S1518-8787.2017051006802
M3 - Article
C2 - 28746576
AN - SCOPUS:85029668054
SN - 0034-8910
VL - 51
JO - Revista de saude publica
JF - Revista de saude publica
M1 - 67
ER -