Descritores Vacinação. Programas de imunização. Acesso aos serviços de saúde.Reforma do setor saúde. Colômbia. Abstract ObjectiveTo assess the effects of individual, household and healthcare system factors on poor children's use of vaccination after the reform of the Colombian health system. Methods A household survey was carried out in a random sample of insured poor population in Bogota, in 1999. The conceptual and analytical framework was based on the Andersen's Behavioral Model of Health Services Utilization. It considers two units of analysis for studying vaccination use and its determinants: the insured poor population, including the children and their families characteristics; and the health care system. Statistical analysis were carried out by chi-square test with 95% confidence intervals, multivariate regression models and Cronbach's alpha coefficient. ResultsThe logistic regression analysis showed that vaccination use was related not only to population characteristics such as family size (OR=4.3), living area (OR=1.7), child's age (OR=0.7) and head-of-household's years of schooling (OR=0.5), but also strongly related to health care system features, such as having a regular health provider (OR=6.0) and information on providers' schedules and requirements for obtaining care services (OR=2.1). ConclusionsThe low vaccination use and the relevant relationships to health care delivery systems characteristics show that there are barriers in the healthcare system, which should be assessed and eliminated. Non-availability of regular healthcare and deficient information to the population are factors that can limit service utilization.

Este artículo tiene por objeto evidenciar la capacidad de respuesta de los sistemas de información en salud (SIS) en Colombia para soportar un modelo de inspección, vigilancia y control (IVC) orientado al seguimiento de los riesgos que menoscaban el acceso, el uso y la calidad de los servicios de salud. Se realizó un estudio transversal, descriptivo, desde el enfoque de gestión de riesgos, que incluyó una revisión del marco regulatorio de las amenazas para el goce efectivo del derecho (GED) a la salud y las características de la información reportada por los actores del sistema, requeridas para su seguimiento. Los datos que soportan el seguimiento a los procesos de atención y su impacto sobre la salud poblacional resultan insuficientes para hacer una adecuada supervisión de los riesgos. Se deben aprovechar los cambios que experimenta actualmente el sistema de salud para replantear la forma en que su desempeño es objeto de seguimiento.

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