Linha de cuidado do câncer do colo do útero em municípios de pernambuco: práticas, desafios e perspectivas da atenção primária à saúde

Abstract

mong public health issues, cervical cancer is one of the most common types in the female population, considered a global public health problem. In Brazil, there is still high morbidity and mortality from this type of cancer, with the worst indicators in the Northeast and North regions of the country. Thus, this study aims to analyze the line of care for cervical cancer in the municipalities of the State of Pernambuco, from the perspective of Primary Health Care professionals. This is a cross-sectional, exploratory with a qualitative approach. The research was carried out in five municipalities in the State of Pernambuco. The social actors of the research were professionals who work in Primary Health Care. The data collection instruments used are semi-structured questionnaires. The interviews were transcribed and analyzed using the ATLAS.ti 22 qualitative data analysis software. This research complied with the bioethical principles described in the Resolução nº 466/12 do Conselho Nacional de Saúde and was approved by the Comitê de Ética em Pesquisa under protocol number 5,281,269. The main strategy used for the early detection/screening of cervical cancer in the cities of the study is the Pap smear. It is observed that there is no homogeneous dissemination of the exam, and it is up to each Family Health Team to periodically carry out the planning of actions aimed at tracking and improving the coverage of the exam. In most units, marking is carried out on a spontaneous demand basis. There was a decrease in the number of vacancies motivated by biosecurity issues in the units due to the COVID-19 pandemic. In the analysis of the services, the units do not have registration mechanisms for the identification and active search of women with an overdue exam, although some municipalities have started using data from the Programa Previne Brasil, capturing these is dependent on the demand for the health service . There are reports of difficulties in referring women to the tertiary unit. As strengthening factors, municipalities are investing and seeking to qualify and computerize work processes through the purchase of computers, personnel training, but these actions are still in the implementation phase and many units are still working on developing their own registration forms. There is also an increase in the night workload to provide the working women access to the exam in some cities. There are weaknesses that the management has to be solved, such as lack of inputs/materials, human resources, difficulties with the internet, inconsistencies in the systems used, mainly SISCAN and electronic medical records, in addition to the fact that some professionals are still adapting to new technologies. It is concluded that, in general, the identified structure proved to be in the process of adaptation, but the work process of the professionals directly involved proved to be fragile in the face of the activities developed. The contact with all these data allowed the evaluation of the factors involved in the provision of care that could support the analysis and planning of actions aimed at women's health and the maturation of the services of the Unified Health System in the State of Pernambuco