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)

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

doi:10.1590/S0103-05822013000300007

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

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)

Autoría SCIMAGO INSTITUTIONS RANKINGS

OBJETIVO Evaluar la cobertura del Programa Nacional de Suplementación de Ferro (PNSF), el cumplimiento de la normativa de utilización de la suplementación y la asociación con factores sociodemográficos en niños de 6 a 18 meses atendidos en 35 centros de salud informatizados de Florianópolis, Santa Catarina (Brasil).

MÉTODOS Estudio transversal con datos secundarios obtenidos del sistema de informaciones en salud de la Secretaría Municipal de Salud de Florianópolis (Infosaúde). Se obtuvieron informaciones sociodemográficas y sobre la suplementación con sulfato ferroso de todos los niños registrados en el PNSF en Florianópolis, en 2010. Se utilizó el software STATA 11.0 en los análisis.

RESULTADOS La cobertura del PNSF en niños fue igual a 6,3% (IC95% 5,9-6,7), entre los que la normativa de la edad de inicio y la periodicidad de la suplementación se cumplió en solamente un 2,4% (IC95% 1,5-3,7) de los casos. No hubo asociación con el sexo del niño, la escolaridad y el color de la piel materna, tampoco con la distancia del domicilio al centro de salud.

CONCLUSIONES El estudio mostró cobertura baja e inadecuación en el cumplimiento de las normativas del PNSF, siendo urgente la adopción de medidas que mejoren esa estrategia.

anemia; deficiencia de hierro; niño; política de salud; programas nacionales de salud; evaluación en salud

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

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