Acesso aos serviços de saúde de uma comunidade tradicional pesqueira no Nordeste do Brasil: limitações de uma realidade peculiar

Abstract

This study analyzes access to Primary Health Care services in a traditional fishing community in Northeastern Brazil. The results are presented in two separate chapters. In the first, an approach was made on the issue of the situational diagnosis of scientific production through an Integrative Review in the databases of Latin American and Caribbean Literature in Health Sciences (LILACS); Scientific Electronic Library Online (SciELO); Medical Literature Analysis and Retrieval System Online (MEDLINE); and in the US National Library of Medicine (PubMed), considering publications in full from 2014 to 2019, in Portuguese, English and Spanish using the descriptors Access to health services, Rural Population and Brazil. And, in the second, the results obtained from an epidemiological study carried out in the community of Bananeiras, Ilha da Maré - BA in 2018 were presented and discussed. The results of the integrative review showed that in 2014 no publications were found. In the following years, production was distributed as follows: 16.7% published in 2015, 11.1% in 2016, 11.1% in 2017, 44.4% in 2018 and 16.7% in 2019. Approximately 88, 9% of the studies were published in Portuguese and 11.1% in English. Regarding publication journals, it was found that 68.7% are journals linked to the Public Health area, 6.2% in the Psychology area, 25% Nursing. Regarding the quality of the magazines, 62.5% of these journals are classified between A1 and B1. Approximately 11.1% of the studies identified were nationwide. At the regional level, most of the research was concentrated in the South and Midwest regions of the country. The North and Northeast regions presented 16.7% and 11.1% of the total scientific production, respectively. Approximately 61% of the studies addressed some dimension of access to health services in rural populations. Among them, the most prevalent approaches were related to displacement and accessibility. The results of the epidemiological study showed that distance has been one of the main factors associated with the difficulty of accessing health services, and it is verified that those who reach their homes through unpaved ground have even more difficulty than those who arrive at boat. This fact can probably be explained by the dirt path becoming longer, considering that the outcome variable of the study was calculated from the travel time of the participants from their residence to a health unit. The study also pointed out as factors associated with the lack of access to health services, the lack of knowledge in public policies by the residents of the community of Bananeiras, not finding other research that could support this finding, which points to the need to conduct studies that enable a better understanding of this relationship. At the end of the study, it is concluded that access to public health services is hampered mainly by the distance and time of travel to the service units, with knowledge about public policies and daily working time also verified as an associated factor.