Qualidade do sistema de informações sobre nascidos vivos no Estado do Paraná, 2000 a 2005

Abstract

The Information Systems in Health are used in the indicators construction that identify the state of health of each region and in the health policies directions. The Information System of Live Births (SINASC) of the Health Ministry was established to provide beyond the counting births, the mother characteristics, pregnancy, childbirth and the newborn. The goal of this dissertation was to evaluate the SINASC quality in the Paraná state in the period of 2000 to 2005. This study, descriptive was conducted with all live births occurred in the Paraná state in the period 2000 to 2005 contained in SINASC. It was studied the SINASC quality through the no declaration of variables relating to the mother (age, marital status, education, occupation, children born live and children born dead), the gestation (length of gestation, type of pregnancy and pre- natal consultations), the childbirth (type of childbirth and place of occurrence) and the newborn (sex, weight, Apgar score at 1st and in the 5st minute, race / color and congenital malformation) for the Paraná State and their Macro regions and Regional Health (RS). It was drawn up a classification for quantifying the SINASC quality based on the variables non-declaration percentage. For the last year it was estimated the relative risk of SINASC non-declaration variables according to the site of occurrence, municipality of occurrence, mother's age, mother's education, length of gestation, birth weight and Apgar in the 1st minute. The SINASC quality in Paraná State improved in the period of 2000 to 2005 showing excellent quality for most of the variables in 2005 except to mother's occupation. The variables with lower quality in the period of 2000 to 2005 were: mother's schooling, mother's occupation, children born live, children born dead, prenatal care, race / color of the newborn and congenital malformation. For 2005 there was observed the need for improvement in the variable declaration: marital status in the Telêmaco Borba, Jacarezinho and Francisco Beltrão Regional; mother's occupation in all RS; children born alive in the Umuarama, Francisco Beltrão, Foz do Iguaçu and Toledo Regional; children born dead in the Jacarezinho, Cianorte, Paranavaí, Francisco Beltrão, Foz do Iguacu and Toledo Regional and Apgar at 1st and in the 5th minute in the Foz do Iguacu Regional. The risk of non-declaration was higher for births occurring outside of hospitals for all variables except type of birth and sex. With the exception of the variables: type of pregnancy, type of birth, sex and race / color, the risk of non-declaration was higher in not headquarters municipalities for most of the variables except the occupation which the risk of non-declaration was higher for headquarters municipalities. The risk of non-declaration was higher for mothers with age < 20 years to marital status, children born live and children born dead. The risk of non-declaration was higher for mothers with < 3 years of study to marital status, length of gestation, birth weight, Apgar scores at 1st and in the 5st minute and race / color. The risk of non-declaration for pregnancy duration < 37 weeks was higher for education, pre-natal consultations, sex, birth weight, Apgar score at 1st and in the 5st minute and race / color. The risk of non-declaration for birth weight < 2,500 g was higher for pregnancy duration, pre-natal consultations, sex and Apgar at 1st and in the 5st minute, and the risk of non-declaration was higher for birth weight > 2,500 g for children born live and children born dead. The risk of non-declaration to Apgar in the 1st minute < 8 was higher for marital status, children born live, children born dead, sex and Apgar in the 5st minute. Excellence in the declaration of SINASC variables demonstrated its potential as a source of information for planning actions on Paraná maternal-child health. It is the fundamental the importance of investment in the SINASC quality to be an important source of information of the population not only users of the Unified Health System.