Avaliação do sistema de vigilância epidemiológica no Estado do Ceará frente ao modelo de descentralização do Sistema Único de Saúde

Abstract

The aim of this research was to evaluate the Epidemiological Surveillance System (ES) of the State of Ceará - Brazil, in what concerns the decentralisation model. The present work consisted of a transversal study conducted with the Epidemiological Surveillance’s Co-ordinators of the municipalities from the State of Ceará, throughout the period of Januaiy to December, 2002. There were included in the research, 184 municipalities from the State, but the final sample consisted of 149 municipalities due to 8 of them did not have a The Co-ordinators’ Epidemiological Surveillance and 25 did not answer the questionnaire. The results pointed out that 54,36% municipalities were certified for the Gestão Plena de Atenção Básica, while only 12,75% of the municipalities were in Gestão Plena do Sistema Municipal. In relation to the municipalities’ certification for Epidemiology and Disease Control (CDC), 62,41% of them were certified. The Co-ordinators’ profíle evaluation showed that, 87,91%, were women with a varying age between 26 to 40 years (69,79%); 82,43% worked in the ES and in other activities related to health, receiving a mean wage of R$ 1.312,00 (around US$ 437,00) and did not have working bounds. The health teams had a médium of 1,4 professional. Analysing the available infra-structure, only 59,06% of the municipalities had an exclusive location for the development of the surveillance activities, 96,64% had computers, followed by 93,95% with phone access, but only 69,79% had the conditions to access the internet and only 32,21% of them had the availability oftransport. Only 19 of the 149 municipalities had a performance considered adequate in relation to the Epidemiological Surveillance’s actions. The type of management (p = 0,018) and the surveillance team be composed by both a technician and a graduated professional (P=0,029) were the only factors significantly associated with an adequate performance by ES. In the quotidian practice of ES actions, it is clearly noticed the predominance of the traditional model and that even after the decentralisation of the CDC, these activities do not seem to be prioritised by the municipalities.