Access of children in chronic condition to primary care: a descriptive exploratory study

Daisy Cristina Rodrigues1, Eliane Tatsch Neves1, Leonardo Bigolin Jantsch1, Andressa da Silveira1
1Federal University of Santa Maria


Aim: to describe the access of children in chronic conditions to primary health care from the perspective of health professionals. Method: this is an exploratory and descriptive study, using a qualitative approach. For the collection of data, semi-structured interviews will be carried out with health professionals that integrate the teams of Basic Health Units and the Family Health Strategy in the South of Brazil. The data will be treated through the thematic inductive analysis. Expected results: the expectation is to contribute with resources for the planning of the assistance, allowing access for the coordination of care. In addition to encouraging moments and spaces for reflection for the health professionals participating in the study, who can rethink their daily practices.

Descriptors: Child Health; Health Services Accessibility; Chronic Disease; Primary Health Care.


Improved living conditions, technological progress, and economic and social development have enabled more accurate diagnoses and more appropriate therapy. These factors contributed to the reduction of infant mortality, leading to an increase in the survival of children and altering the morbidity profile, characterized by a decline in acute problems and the rise of chronic conditions(1).

The child in chronic condition needs to be assisted at all levels of health care. In this sense, Primary Health Care (PHC) is one of the essential points of attention, a component of an integrated health services system, responsible for organizing and coordinating the interaction between all services(2).

One of the attributes of the PHC is to ensure universal access to health services, fostering child and family and promoting the linkage of care to their health needs(3).

Access to the user is based on the reception, qualified listening and offer of a service that involves resoluteness and accountability for the follow-up of care(3). Thus, health professionals can meet the demands of the child in a chronic condition, through singular and integral care, which will only be possible if such clients have access to services.

This study is justified by the relevance of knowing the perception of health professionals in terms of the access of the child in a chronic condition, which presents itself as one of the knowledge gaps related to the research topic.


How is the access of children in chronic condition to PHC from the perspective of health professionals?


To describe the access of children in chronic condition to PHC from the perspective of health professionals.


This study was originated from a multicenter research project entitled "Children with special health needs in basic health care service: prevalence and access", which is being developed in the municipalities of Ribeirão Preto/SP, Rio de Janeiro/RJ and Santa Maria/RS.

This is an exploratory and descriptive study, using a qualitative approach, whose scenarios will be the Basic Health Units and the Family Health Strategy (FHS) of Santa Maria/RS.

The urban health units were selected from a lottery conducted in Phase I of the multicenter project, constituting eight units in Santa Maria/RS. Collecting will be started by the first unit drawn, and so on consecutively.

The study population will be composed of health professionals (physicians, nurses, technicians and nursing assistants, community health agents and dentists) who are members of the teams that attend children.

It was established as an inclusion criterion: to be a health professional working in one of the selected units. And as an exclusion criterion: to be absent from work by license of any nature (pregnancy, sickness), in the period established for data collection, namely: April to June 2016.

Semi-structured interviews will be developed, written in two parts: (a) related to the data of training of health professionals, with closed questions; (B) consisting of open questions related to the professionals' perception regarding the theme and questions elaborated with vignettes, from studies about the perception of caregivers and their relatives on the access of children to health services.

The interviews will be held at previously scheduled times, individually, according to availability. These interviews will be recorded with the consent of the interviewee, fully recording the speech and ensuring authentic material for the analysis. Afterwards, an independent double transcription will be performed, seeking to identify possible incongruities and inconsistencies in the empirical material. The completion of the interviews will be based on the theoretical density of the data, which will be estimated after 30 interviews. For data treatment, the inductive thematic analysis, which is operationally divided into six stages, will be used: familiarization with the data; generation of the initial codes; search for themes; review of the identified themes; definition and naming of themes; and preparation of the final report.

The project was approved by the Ethics Committee in Research of the Federal University of Santa Maria under Certificate of Presentation for Ethical Assessment no. 2.0000.5346, according to ethical precepts determined in Resolution no. 466/2012.


It is hoped to contribute with the planning of the assistance, allowing the access for the coordination of the care; promote reflection spaces for the health professionals participating in the study, who will be able to rethink their daily practices; And, finally, it is hoped to promote support to the realization of new studies related to the thematic, collaborating for the construction of knowledge in nursing and health.


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  2. Modes PSSA, Gaíva MAM. Structure of children’s basic health units: descriptive study. Online Braz J Nurs (Online) [internet]. 2013 Sept [Cited 2016 Mar 19]; 12 (2): 471-81. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/3624
  3. Finkler AL, Viera CS, Tacla MTM, Toso BRGO. The access and the difficulty in resoluteness of the child care in primary health care. Acta Paul. Enferm. [internet]. 2014 Dez [Cited 2016 Mar 20]; 27(6): 548-53. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002014000600548&lng=pt. http://dx.doi.org/10.1590/1982-0194201400089.

All authors participated in the phases of this publication in one or more of the following steps, in According to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the versión submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf

Received: 03/24/2016 Revised: 05/24/2016 Approved: 05/24/2016


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