Cobertura e adequação da atenção pré-natal e do exame preventivo do câncer de colo do útero nas regiões Sul e Nordeste do Brasil.

Abstract

Women's health is taken as a constant concern in the context of global public health policies. The different patterns of health of the woman observed between developed and developing countries imply in different programmatic interventions to strengthen health systems. Thus, actions that involve the health of women must include prevention, promotion, treatment and recovery of health of individuals and their families. Among the health actions directed to women, prenatal care and cervical cancer prevenction are the most traditionals and that have the ability to create best opportunities to prevent disease and the appropriate diagnosis and treatment of complications. Considering the relevance of the issue for public policy aimed at women's world health, this study seeks to know the coverage and adequacy of prenatal care and Pap test in women in cities with more than 100 thousand inhabitants of the South and Northeast regions of Brazil, in the perspective of primary health care. I emphasize that this volume will be displayed just the study of the coverage and adequacy of Pap test, leaving the results related to prenatal care for future publication. The investigation of the coverage and adequacy of Pap test and associated factors was carried out using a cross-sectional study in 2005 on a sample of 3939 women who had children in the last two years prior to the survey. Women living in areas covered by primary health care in 41 municipalities, with more than 100,000 people in seven states of Brazil. Pap test was considered adequate when performed in the last three years. The coverage of the examination was 75.3%, with no significant difference between regions. The prevalence of adequacy was 70.7% in the total sample, 69.4% in the South and 71.8%, in the Northeast. The adequacy of the Pap test was positively associated with age over 25 years, higher education, conducting pre-natal care in last pregnancy and have consulted for gynecological examination last year. On the other hand the adequacy was less frequently among women of lower socioeconomic status and primiparous. The indicators of coverage and adequacy were below the parameters recommended by the World Health Organisation for the effective control of cervical cancer. Therefore, it is necessary to strengthen the preventive actions offered by the health services for vulnerable subgroups of women.