Programa Saúde na Escola no Ceará: descrição das ações com base no Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica

Abstract

The Health in School Program (PSE), an intersectoral policy developed by the Ministries of Health and Education, has been working on the essential training of students through health promotion, disease prevention and health care actions. The study aimed to describe the health promotion actions of the Family Health Teams (EqSF) linked to the PSE and the characteristics of the microcontext and macrocontext associated, comparing data from the National Program for Improvement of Access and Quality of Basic Care (PMAQ -AB) in Ceará socialized in 2012 and 2014. Repeated cross-sectional survey, with a quantitative approach, carried out using data provided by the Ministry of Health in a survey conducted with 910 EqSF (1st cycle) and 1,626 EqSF (2nd cycle) that joined PMAQ-AB in Ceará. Data from module II were used, specifically the questions related to health promotion actions developed by EqSF in the school context, present in an evaluation instrument, applied in the external evaluation phase of the program. For data organization purposes, the municipalities were classified according to their health macro-region, population size, percentage of population coverage estimated by the Family Health Strategy (ESF) and the PMAQ-AB certification stratum. The data were consolidated and inserted into the statistical program Stata® v.13.0 and analyzed using descriptive and analytical statistics. The research was approved by the Research Ethics Committee under opinion No. 21904. The results showed that most of the professionals who responded to the research were nurses, working between 1 to 5 years at EqSF, who participated or concluded postgraduate courses. There was a significant increase in the percentage of EqSF who reported carrying out actions aimed to promote the health of adolescents in the years of study. According to the contextual characteristics, the most significant increase in actions occurred in the municipalities belonging to the macro-regions 1 (Fortaleza), 2 (Sobral) and 3 (Sertão Central), with small to medium population size, with strata of the PMAQ-AB from low to median and with high proportions of population coverage estimated by the ESF. Regarding the descriptive variables, there was an increase of actions in both axes recommended by the PSE, with greater magnitude for clinical evaluation, higher increases for the ophthalmological evaluation, detection of neglected diseases and auditory evaluation. For health promotion actions, the highest increases occurred in actions promoting physical activity, training of education professionals and debating with school teachers. It is concluded that, over the years, there has been an increase of health promotion actions among students in Ceará, with nurses standing out in the execution of these actions. It is reinforced that in order to obtain positive results with the PSE, it is necessary to expand the ESF coverage in territories. It is expected that the significant number of actions carried out will collaborate in reducing the vulnerabilities of assisted adolescents, impacting on their quality of life, and contributing to changes in the panorama of health conditions that affect the Brazilian population.