Coverage of the Family Health Strategy and uterine colon citopathology in Rio Grande do Sul

Abstract

Rio Grande do Sul showed in the last five years a significant increase in the population coverage provided by the Family Health Strategy (FHS). The changes in the organization of Primary Care proposed by the FHS already demonstrated in the great urban centers improvement in the access and other attributes of Primary Care services, as demonstrated in studies that evaluated indicators of child health when comparing the FHS with the traditional Primary Care services. This study sought analyzing the association between the population coverage of the FHS and the coverage of citopathological exams of the uterine colon among women between 25 and 59 years of age in cities of Rio Grande do Sul. This is an ecological study that used the base of secondary data of the DATASUS originating from SISPACTO over the period January to December 2006. One of the indicators of the health pact was chosen for evaluating the actions directed to women’s health – the number of cervicovaginal citopathological exams performed in the population of interest. The data were stratified into 6 groups according to the population coverage in the cities (without FHS, up to 20%, from 20% to 40%, from 40% to 60%, from 60% to 80% and more than 80% of coverage). For evaluating the influence of the population size, cities with less than 10 thousand inhabitants were compared with the others. The analysis was performed using the software SPSS v13.0 for variance analysis and post hoc test (Turkey) for comparison between the coverage groups and T test for comparison of means according to the population size. As a result, one group of greater coverage showed a statistically significant difference from the group with less than 60% of coverage (p<0,05). It has to be noted that in the covered groups there is a statistically significant difference between the ratios of citopathological exams (CP) according to the population size. Analyzing only the cities with more than 10 thousand inhabitants, we observe that cities with more than 60% of coverage presented a ratio of CP exams statistically higher than those wit up to 20% (p<0,01). These findings show that changes in the organizational model of care through a greater FHS coverage in the cities are also associated with an improvement of the indicators of women’s health actions.