Coverage and adequacy of ferrous sulfate
					supplementation in the prevention of anemia among children treated at health
					centers of Florianopolis, Santa Catarina

Cembranel, Francieli; Corso, Arlete Catarina T.; González-Chica, David Alejandro

doi:10.1590/S0103-05822013000300007

Acessibilidade / Reportar erro

Brasil

Revista Paulista de Pediatria

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. paul. pediatr. 31 (03) • Sept 2013 • https://doi.org/10.1590/S0103-05822013000300007 copy

Coverage and adequacy of ferrous sulfate supplementation in the prevention of anemia among children treated at health centers of Florianopolis, Santa Catarina

Cobertura y adecuación de la suplementación con sulfato ferroso en la prevención de anemia entre niños atendidos en centros de salud informatizados de Florianópolis, Santa Catarina (Brasil)

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

To evaluate the National Program of Iron Supplementation (PNSF) coverage, the compliance with the directions for of using of this supplementation and the association with sociodemographic factors in children aged six to 18 months old and registered in 35 public health centers of Florinópolis (Southern Brazil).

METHODS

Cross-sectional study using secondary data obtained from the health information system of the Health Department of Florianópolis, Santa Catarina, Brazil (Infosaúde). Data on ferrous sulfate supplementation and sociodemographic variables were obtained of all children registered in PNSF in Florianópolis in 2010. STATA 11.0 software was used in the analyses.

RESULTS

The PNSF covered 6.3% (95%CI 5.9-6.7) of the children; the compliance with the directions regarding age at the onset of supplementation and its frequency was adequate only in 2.4% of the cases (95%CI 1.5-3.7). There was no association with the child's gender, maternal education level and ethnicity or the distance from home to the health center.

CONCLUSIONS

This study showed low coverage and inadequate compliance with the PNSF directions. Measures to improve this strategy are urgent.

anemia; iron deficiency; child; health policy; national health programs; health evaluation

Variables	n	%	95%CI
Gender
Female Male	389 445	2.2 2.6	1.3–3.4 1.6–3.8
Maternal skin color
White Other	609 154	2.1 2.5	1.2–3.4 1.5–3.9
Maternal education level (years)
0–8 9–11 ≥12	375 329 59	3.2 1.2 1.6	2.0–4.6 0.5–2.2 0.8–2.7
Geographical area of the health center
Downtown Continent East North South	212 126 46 189 261	1.6 0 0 5.1 2.6	0.8–2.7 – – 3.8–6.9 1.7–4.0
Distance from home to health center (km)
< 1 1–3 >3	310 339 185	2.1 2.3 3.0	1.3–3.4 1.4–3.5 2.0–4.4
Age at the onset of supplementation (months)
≤6.5 (adequate) >6.5–9 (intermediate) >9 (inadequate)	363 238 233	43.6 28.5 27.9	40.1–47.0 25.5–31.7 24.9–31.1
Age at the onset of supplementation (months)
≤6.5 (adequate) >6.5–9 (intermediate) >9 (inadequate)	363 238 233	43.6 28.5 27.9	40.1–47.0 25.5–31.7 24.9–31.1
Frequency of obtainment of ferrous sulfate bottles (months)
≤3.5 (adequate) >3.5 and < 6 (intermediate) ≥6 (inadequate)	61 92 681	7.3 11.0 81.7	5.6–9.3 9.0–13.4 79.0–84.3

				Compliance with PNSF normatives regarding supplementation use
Variables	n	Adequate		Intermediate		Inadequate		p-value
		%	95%CI	%	95%CI	%	95%CI
Gender
Female Male	389 445	2.2 2.6	1.3–3.4 1.6–3.8	9.9 5.3	7.9–12.1 4.0–7.2	88.0 92.1	85.6–90.1 90.0–93.8	0.051
Maternal skin color
White Other	609 154	2.1 2.5	1.2–3.4 1.5–3.9	7.2 9.3	5.5–9.3 7.3–11.6	90.7 88.2	88.4–92.7 85.7–90.4	0.651
Maternal education level (years)
0–8 9–11 ≥12	375 329 59	3.2 1.2 1.6	2.0–4.6 0.5–2.2 0.8–2.7	8.1 6.8 9.0	6.3–10.3 5.1–8.8 7.1–11.3	88.7 92.0 89.4	86.3–90.9 89.8–93.8 87.0–91.5	0.435
Geographical area of the health center
Downtown Continent East North South	212 126 46 189 261	1.6 0 0 5.1 2.6	0.8–2.7 – – 3.8–6.9 1.7–4.0	8.0 7.0 10.3 9.6 5.2	6.2–10.0 5.4–9.0 8.3–12.6 7.7–11.8 3.8–6.9	90.4 93.0 89.7 85.3 92.2	88.2–92.3 91.0–94.6 87.4–91.7 82.7–87.6 90.2–93.9	0.001
Distance from home to health center (km)
< 1 1–3 >3	310 339 185	2.1 2.3 3.0	1.3–3.4 1.4–3.5 2.0–4.4	6.9 7.7 7.9	5.3–8.9 6.0–9.7 6.2–10.0	90.9 90.1 89.1	88.7–92.8 87.8–92.0 86.8–91.1	0.962

				Adequacy of child's age at the onset of ferrous sulfate supplementation
Variables	n	Adequate		Intermediate		Inadequate		p-value
		%	95%CI	%	95%CI	%	95%CI
Gender
Female Male	389 445	43.6 43.5	40.3–47.1 40.1–47.0	29.9 27.3	26.8–33.1 24.3–30.5	26.5 29.1	23.5–29.6 26.1–32.4	0.618
Maternal skin color
White Other	609 154	44.5 42.0	41.0–48.2 38.4–45.5	27.0 29.2	23.9–30.3 26.0–32.6	28.5 28.9	25.3–31.8 25.6–32.2	0.817
Maternal education level (years)
0–8 9–11 ≥12	375 329 59	44.2 44.5 40.2	40.6–47.8 40.9–48.0 36.6–43.7	25.2 27.6 40.8	22.1–28.4 24.5–31.0 37.3–44.3	30.6 27.9 19.1	27.4–34.1 24.8–31.3 16.4–22.1	0.131
Geographical area of the health center
Downtown Continent East North South	212 126 46 189 261	39.8 37.5 27.6 49.4 48.2	36.5–43.2 34.2–40.9 24.6–30.8 46.0–52.9 44.8–51.7	34.4 31.0 21.8 30.0	31.2–37.8 27.9–34.3 19.1–24.8 26.9–33.2	28.1 41.4 28.9 21.9	25.2–31.4 38.0–44.8 25.8–32.1 19.1–24.8	0.036
Distance from home to health center (km)
< 1 1–3 >3	310 339 185	38.4 44.8 50.1	35.1–41.8 41.3–48.2 46.7–53.6	30.9 28.2 25.2	27.8–34.2 25.2–31.4 22.3–28.3	30.7 27.1 24.7	27.6–34.0 24.1–30.3 21.8–27.8	0.165

				Adequacy of the frequency of obtainment of ferrous sulfate bottles
Variables	n	Adequate		Intermediate		Inadequate		p-value
		%	95%CI	%	95%CI	%	95%CI
Gender
Female Male	389 445	7.9 6.7	6.2–10.0 5.1–8.6	12.8 9.4	10.6–15.3 7.5–11.5	79.3 83.9	76.3–82.0 81.3–86.4	0.225
Maternal skin color
White Other	609 154	7.1 8.3	5.4–9.1 6.5–10.6	10.5 14.3	8.4–12.9 11.9–17.0	82.5 77.3	79.6–85.1 74.2–80.3	0.329
Maternal education level (years)
0–8 9–11 ≥12	375 329 59	8.8 6.1 4.7	6.9–11.0 4.5–8.0 3.3–6.5	10.6 11.9 12.1	8.4–12.9 9.7–14.4 9.8–14.6	80.6 82.0 83.2	77.6–83.4 79.1–84.7 80.4–85.8	0.612
Geographical area of the health center
Downtown Continent East North South	212 126 46 189 261	5.6 3.9 3.5 14.7 5.6	4.2–7.4 2.7–5.5 2.3–5.0 12.4–17.3 4.1–7.3	12.8 10.2 20.7 12.2 7.4	10.5–15.2 8.2–12.5 18.0–23.7 10.1–14.7 5.8–9.4	81.7 85.9 75.9 73.1 87.0	78.9–84.2 83.4–88.3 72.9–78.8 69.9–76.0 84.6–89.3	0.001
Distance from home to health center (km)
< 1 1–3 >3	310 339 185	6.5 5.6 11.7	4.9–8.4 4.2–7.4 9.6–14.1	10.9 10.7 11.7	8.9–13.2 8.7–13.0 9.6–14.1	82.6 83.7 76.5	79.9–85.1 81.0–86.1 73.5–79.3	0.133

Sociedade de Pediatria de São Paulo R. Maria Figueiredo, 595 - 10o andar, 04002-003 São Paulo - SP - Brasil, Tel./Fax: (11 55) 3284-0308; 3289-9809; 3284-0051 - São Paulo - SP - Brazil
E-mail: rpp@spsp.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Endereço para correspondência: David Alejandro González-Chica Centro de Ciências da Saúde, 3º andar - Campus Universitário CEP 88040-900 - Florianópolis/SC E-mail: david.epidemio@gmail.com