Avaliação de um programa cearense de atendimento em saúde à crianças e adolescentes vítimas de violência sexual

Abstract

Introduction: The panorama of sexual violence against children and adolescents in Brazil points to the need for increasingly specialized services in the public health sector to care for these victims, given that it is a silent, multidimensional phenomenon that triggers a series of post-traumatic events that translate into physical, psychological, emotional, social, and sexual consequences, as well as negative changes in child and adolescent development. Contributing to this status of specialized services requires monitoring and evaluating existing care programs to identify gaps and potentialities and propose strategies to strengthen services. Objective: To evaluate a referral program that cares for children and adolescents who are victims of sexual violence in a pediatric hospital in Ceará, from the perspective of the multidisciplinary team. Methodological approach: Qualitative, exploratory, and descriptive study, with data collection using documentary research, semi-structured interviews, and questionnaires administered to the multidisciplinary team and management of a program serving victims of child and adolescent sexual violence at a referral pediatric hospital in Fortaleza, Ceará. Eighteen health professionals were interviewed and a questionnaire was administered to the program coordinators. The evaluation followed the epistemological assumptions of the In-Depth Evaluation (IDE) method, with data analysis based on Thematic Content Analysis in light of existing literature on sexual violence against children and adolescents. The study was approved by the Research Ethics Committee of the Federal University of Ceará, according to opinion number: 7,500,752. Presentation of findings: The program is recognized by the multidisciplinary team as a strategic and necessary tool in combating sexual violence against children and adolescents, standing out for its welcoming approach, comprehensive care perspective, and coordinated action between emergency care and outpatient follow-up. Among its strengths are professional training, the expansion of the clinical perspective beyond the biomedical dimension and attention to children, adolescents, and families, and the recognition of the program as a state reference. On the other hand, challenges emerge related to interprofessional coordination and communication in the performance of care flows and also in intersectoral coordination (which is already represented in the existing literature and expands the alert to the need for new strategies), in addition to the presence of structural limitations and work overload, aggravated by the emotional impact on professionals, with a need for institutional strategies for worker health care, as these challenges are aspects that directly impact the operationalization of care and the effectiveness of comprehensive care. Final considerations: It is concluded that the evaluation of the program, from the perspective of the multidisciplinary team, revealed institutional, organizational, and relational dimensions that are fundamental for the qualification of health care for children and adolescents who are victims of sexual violence, and for the institutional well-being of those who provide care. The research reaffirms the importance of qualitative and counter-hegemonic evaluation processes, capable of valuing the experiences of professionals and supporting critical reflections on the work process. By highlighting potentialities and weaknesses, the study contributes to the strengthening of the Ponto de Luz Program, the improvement of multiprofessional practices, and the consolidation of comprehensive protection in the public health sphere, broadening the debate on the evaluation of specialized services in combating sexual violence against children and adolescents.