The traditional model for dengue control in Brazil has established that community participation is one of its main strategic pillars. In practice, this strategy has been unable to promote the involvement and behaviour change of the population, which are considered essential to control this endemic disease. In the present study, we carried out an integrative review of articles published in the scientific literature on knowledge, attitudes and practices of the population about the disease. This method was chosen because it allows gathering and synthesizing research findings on the selected theme, thus contributing to enhance knowledge on the investigated subject. We conclude that there is a gap between the government's actions and the population's reality, which suggests the need to implement a less vertical prevention and control policy, in which social knowledge can guide strategies for disease control in accordance with the community's interests, needs, desires and worldviews. In this perspective, the population ceases to be a mere spectator, dependent on previously defined actions, and occupies a prominent position in the process, ensuring the effectiveness and sustainability of the program's activities.
This study aimed to assess the effect of the expansion of the Family Health Strategy (FHS) on hospitalizations for primary care sensitive conditions (PCSCs) in children under one year of age. This was a longitudinal ecological study with the use of panel data, for which the analytical units were the 417 municipalities (counties) in Bahia State, Brazil, from 2000 to 2012. Data were obtained from the official health information systems. The hospitalization rate for PCSCs was the outcome and FHS coverage was the principal exposure. The co-variables referred to demographic and socioeconomic characteristics and the local availability of pediatric beds. Bivariate and multivariate panel data analyses were performed, with negative binomial response and fixed effects models, using crude and adjusted relative risk (RR) as the measure of association, with the respective confidence intervals. To control for trend effect, the models were adjusted for time. From 2000 to 2012, 248,944 hospitalizations for PCSCs were recorded in children under one year, and the median municipal rate of hospitalizations for PCSCs decreased by 52.5% during the period, ranging from 96.9 to 46.0 avoidable hospitalizations per 1,000 live births. After adjusting the model, the reduction in avoidable hospitalizations was maintained at the different FHS coverage levels. This study demonstrated the effects of the consolidation of the FHS on hospitalizations for PCSCs in infants, which indicates the importance of strengthening primary care measures in order to offer case-resolving care during the first contact with the health system and avoid unnecessary hospitalizations.
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