Integration of endemic disease control workers in the Family Health Strategy, Campo Grande, Mato Grosso do Sul, Brazil, 2017

Pereira, Glória de Araújo; Pícoli, Renata Palópoli; Cazola, Luiza Helena de Oliveira

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Epidemiologia e Serviços de Saúde

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Research note • Epidemiol. Serv. Saúde 30 (1) • 2021 • https://doi.org/10.1590/S1679-49742021000100018 copy

Integration of endemic disease control workers in the Family Health Strategy, Campo Grande, Mato Grosso do Sul, Brazil, 2017^* * Manuscript derived from the Master’s Degree dissertation entitled ‘Integration of endemic disease control workers in the Family Health Strategy’, defended by Glória de Araújo Pereira at the Family Health Postgraduate Program, Federal University of Mato Grosso do Sul (UFMS), in 2018.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To describe the process of Endemic Disease Control Worker (EDCW) integration into the Family Health Strategy.

Methods

This was a descriptive cross-sectional study. Data were collected through a self-administered semi-structured questionnaire, from February to May 2017, in four Family Health centers in the urban region of Campo Grande, Mato Grosso do Sul, Brazil.

Results

57 Community Health Agents (CHW) and eight EDCWs participated. All participants reported providing guidance to property dwellers and 58 carried out mechanical vector control during the inspection of properties, in order to avoid and eliminate possible Aedes aegypti breeding sites. With regard to EDCW integration in the Family Health Strategy, 18 participants highlighted teamwork as a positive aspect; while 15 highlighted lack of autonomy to undertake legal interventions as a negative aspect.

Conclusion

EDCW integration in the Family Health Strategy is feasible, however, adjustments need to be made to optimize activities within the perspective of shared work in the same territorial area.

Primary Health Care; Family Health; Dengue; Aedes; Vector Control

Variables	CHW^a (n=57)	EDCW^b (n=8)	Total (n=65)
Variables	n	n	n
Conduct when checklist result unsatisfactory ^c

Gives guidance to dweller	42	2	44
Mechanical vector control of environments	40	2	42
Requests chemical treatment	16	1	17
Refers to the nurse	11	1	12
Requests Health Surveillance measures	5	1	6
Carries out the household visit without any need for additional actions	4	–	4

Use of LIRAa^d

Yes	24	7	31
No	33	1	34

Discussion of LIRAa^d in team meetings

Never	6	2	08
Rarely	11	–	11
Sometimes	18	1	19
Frequently	11	2	13
Always	11	3	14

Influence of LIRAa^d result on the territory

Planning field actions	11	1	12
Visualizing places of greater risk	21	3	24
Intensifying visits	15	3	18
Other	10	1	11

Variables	CHW^a (n=57)	EDCW^b (n=8)	Total (n=65)
Variables	n	n	n
Frequency of team meetings

Weekly	47	6	53
Fortnightly	7	2	9
Monthly	1	–	1
Rarely	2	–	2

Participants of team meetings^c

EDCW^b/CHW^a	57	7	64
Nurse	57	6	63
All team members	18	5	23
Area supervisor	19	6	25

Field supervision

Yes	54	7	61
No	3	1	4

Professional who undertakes field supervision

Nurse	30	–	30
Area supervisor	02	7	09
Nurse/area supervisor	25	1	26

Activities undertaken^c

Gives guidance to dweller on how to avoid and eliminate possible vector breeding sites	57	8	65
Informs dweller about the disease, symptoms, risks, causative agent	55	7	62
Inspects rooms carrying out mechanical vector control	51	7	58
Lets supervisor know about presence of breeding sites	49	7	56
Refers suspected cases to the health center	48	6	54
Updates the property and strategic points register	43	7	50
Inspects rooms to see if there are breeding sites	37	7	44
Inspects rooms and collects larva	5	5	10
Investigates complaints made by neighbors about possible breeding sites in the micro area	6	2	8
Identifies breeding sites and applies larvicide when indicated	2	4	6

Variables	CHW^a (n=57)	EDCW^b (n=8)	Total (n=65)
Variables	n	n	n
Importance of integration

Very important	29	7	36
Important	24	1	25
Not very important	4	–	4

Satisfaction with integration

Satisfied	55	7	62
Dissatisfied	2	1	3

Positive aspects^c

Team work	23	7	18
Sharing information	7	1	8
Immediate case notification	8	–	8
Prioritizing of FHS^d actions	8	–	8

Negative aspects^c

Lack of autonomy to conduct legal interventions	9	6	15
Absence of intersectoral workflow	14	–	14
Absence of integration	5	–	5
Accumulation of work duties	8	2	10

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Glória de Araújo Pereira – Av. Cuiabá, No. 695, Leblon, Campo Grande, MS, Brazil. Postcode: 79092-035. E-mail: gloriagap@gmail.com