Child health: social conditions and health services utilization

Abstract

OBJECTIVES: to identify population segments excluded from the health system or that required specific and
reoriented action from health services.
METHODS: cross-sectional, home study, used a probabilistic sample consisting of 1,099 children under five years old, distributed in four strata of living conditions, living in the municipality of Embu, São Paulo, in 1996. The lottery process adopted was that of conglomerates in two stages, considering two independent populations: children under one year old and children aged one to four years old. Indicators of prenatal, perinatal and child health care were investigated. For statistical analysis, estimates of proportions, standard errors and confidence intervals (95%) were calculated using the CSample program: Epi-info 6.04.

RESULTS:
in all strata, more than 90% of mothers received prenatal care, with late access in stratum four (slums). Around 80% of children under one year of age were monitored in health services; basic health units were most used for vaccination (97.4%) and health monitoring (79.0%) and other health services for unscheduled appointments, with greater demand for private services/insurance plans in stratum one (best conditions). In acute illnesses, the health service was the care option for almost 100% of cases.
CONCLUSIONS: the existence of population segments excluded from the health system was not verified, however some indicators pointed to more pronounced deficiencies in stratum four.