Child health indicators in primary health care and the Covid-19 pandemic
DOI:
https://doi.org/10.32385/rpmgf.v39i3.13447Keywords:
Indicators, Children's health, COVID-19 pandemic, General and family medicineAbstract
Introduction: Several factors can have an impact on child follow-up in the first two years of life, highlighting the COVID-19 pandemic. It is therefore pertinent to know the evolution of child health indicators.
Objective: Study of the dynamics of indicators 269 (index of adequate follow-up in child health in the second year of life) and 302 (index of adequate follow-up in child health in the first year of life) at the national level and by Regional Health Administration (ARS) between January 2018 and January 2021.
Methods: Cross-sectional observational study of the indicators obtained in the Matrix of Indicators of Primary Health Care, disaggregated by national total and Health Region. Descriptive and inferential statistical treatment.
Results: At the national level and from January 2018 to January 2020, indicator 269 had an evolution dynamics (∆)=+0.03, and from January 2020 to January 2021 it had ∆=-0.009. For the same time intervals, indicator 302 had ∆=+0.02 and ∆=-0.02 respectively. Differences were found in the indicators and their dynamics according to the administrative geographic area of health.
Conclusions: The indicator values increased between January 2018 and January 2020 and decreased between January 2020 and January 2021. Differences were found in the values in the follow-up in the first and second years of life. It is worth observing the impact of the COVID-19 pandemic, with a decrease in adherence to vaccination, a decrease in the human resources needed for vaccination, and work overload. Portugal remains until 2020 with good child health indicators in the first two years of life compared to other countries. Further studies are needed to define measures to act on the weaknesses detected and to understand the long-term impact of the COVID-19 pandemic.
Downloads
References
Instituto Nacional de Estatística. Taxa bruta de natalidade (‰) por local de residência (NUTS – 2013): anual [homepage]. Lisboa: INE; 2021 [updated 2023 Mar 31; cited 2021 Dec 01]. Available from: https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_indicadores&contecto=pi&indOcorrCod=0008264&selTab=tab0
Direção-Geral da Saúde. Programa nacional de saúde infantil e juvenil e epidemia de Covid-19: informação nº 008/2020, de 26/03/2020. Lisboa: DGS; 2020.
Dias CM, Freitas M, Briz T. Indicadores de saúde: uma visão de saúde pública, com interesse em medicina geral e familiar [Health indicators: a vision of health of interest to family medicine]. Rev Port Clin Geral. 2007;23(4):439-50. Portuguese
Administração Central do Sistema de Saúde. Bilhete de identidade dos indicadores dos cuidados de saúde primários para o ano de 2017 [Internet]. Lisboa: Ministério da Saúde; 2017 Apr 11 [cited 2021 Dec 1]. Available from: https://www.acss.min-saude.pt/wp-content/uploads/2016/07/bilhete_identidade_indicadores_contratualizacao_2017.pdf
Vieira PA, Barros PJ, Caseiro T, Rodrigues N, Arcanjo J. Efeitos de uma pandemia numa unidade de cuidados de saúde primários e sua população: um estudo retrospetivo [Effects of a pandemic in a primary care unit and its population: a retrospective study]. Rev Port Med Geral Fam. 2021;37(5):393-406. Portuguese
Cabral IE, Pestana-Santos M, Ciuffo LL, Nunes YR, Lomba ML. Child health vulnerabilities during the COVID-19 pandemic in Brazil and Portugal. Rev Lat Am Enferm. 2021;29:e3422.
Fournier JP, Amélineau JB, Hild S, Nguyen-Soenen J, Daviot A, Simonneau B, et al. Patient-safety incidents during COVID-19 health crisis in France: an exploratory sequential multi-method study in primary care. Eur J Gen Pract. 2021;27(1):142-51.
Duncanson M, Wheeler BJ, Jelleyman T, Dalziel SR, McIntyre P. Delayed access to care and late presentations in children during the COVID-19 pandemic New Zealand-wide lockdown: a New Zealand Paediatric Surveillance Unit study. J Paediatr Child Health. 2021;57(10):1600-4.
Williams TC, MacRae C, Swann OV, Haseeb H, Cunningham S, Davies P, et al. Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study. Arch Dis Child. 2021;106(9):911-7.
DeMauro SB, Duncan AF, Hurt H. Telemedicine use in neonatal follow-up programs: what can we do and what we can’t – Lessons learned from COVID-19. Semin Perinatol. 2021;45(5):151430.
Huston P, Campbell J, Russell G, Goodyear-Smith F, Phillips RL Jr, van Weel C, et al. COVID-19 and primary care in six countries. BJGP Open. 2020;4(4):bjgpopen20X101128.
Poppe M, Aguiar B, Sousa R, Oom P. The impact of the COVID-19 pandemic on children's health in Portugal: the parental perspective. Acta Med Port. 2021;34(5):355-61.
Direção-Geral da Saúde. Campanha de vacinação contra a COVID-19: centros de vacinação COVID-19 (CVC): orientação nº 003/2021, de 02/03/2021, atualizada em 29/06/2021. Lisboa: DGS; 2021.
McDonald HI, Tessier E, White JM, Woodruff M, Knowles C, Bates C, et al. Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020. Euro Surveill. 2020;25(19):2000848.
Santoli JM, Lindley MC, DeSilva MB, Kharbanda EO, Daley MF, Galloway L, et al. Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration — United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):591-3.
Zhong Y, Clapham HE, Aishworiya R, Chua YX, Mathews J, Ong M, et al. Childhood vaccinations: hidden impact of COVID-19 on children in Singapore. Vaccine. 2021;39(5):780-5.
Serviço Nacional de Saúde. Bilhete de identidade dos cuidados de saúde primários: contratualização (índice de desenvolvimento global das unidades funcionais [homepage]. Lisboa: Ministério da Saúde; 2021 [cited 2021 Dec 01]. Available from: https://bicsp.min-saude.pt/pt/contratualizacao/idg/Paginas/default.aspx
Serviço Nacional de Saúde. Bilhete de identidade dos cuidados de saúde primários: matriz dos indicadores dos cuidados de saúde primários [homepage]. Lisboa: Ministério da Saúde; 2021 [cited 2021 Dec 01]. Available from: https://bicsp.min-saude.pt/pt/investigacao/Paginas/Matrizindicadorescsp_publico.aspx?isdlg=1
Instituto Nacional de Estatística. Estatísticas vitais 2020 [homepage]. Lisboa: INE; 2021 Apr 27 [cited 2021 Dec 01]. Available from: https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_boui=471108445&DESTAQUESmodo=2
Organisation for Economic Co-operation and Development. Infant mortality rates: indicators [homepage]. Paris: OECD; 2023. Available from: https://data.oecd.org/healthstat/infant-mortality-rates.htm
World Health Organization. World health statistics 2021: monitoring health for the SDGs, sustainable development goals [homepage]. Geneva: WHO; 2021. Available from: https://apps.who.int/iris/handle/10665/342703
Organisation for Economic Co-operation and Development. Child vaccination rates: indicators [homepage]. Paris: OECD; 2023. Available from: https://data.oecd.org/healthcare/child-vaccination-rates.htm
Pereira AL. Indicadores: o que são, o que não devem ser e o que poderão ser [Contractual indicators: what they are, what they should not be and what they might be]. Rev Port Med Geral Fam. 2018;34(3):124-6. Portuguese
Administração Central do Sistema de Saúde. Bilhete de identidade de indicadores de monitorização e contratualização: indicador 442 (índice de acompanhamento adequado em saúde infantil no 1º ano de vida [homepage]. Lisboa: Ministério da Saúde; 2022 [cited 2021 Dec 1]. Available from: https://sdm.min-saude.pt/BI.aspx?id=442&clusters=S
Administração Central do Sistema de Saúde. Bilhete de identidade de indicadores de monitorização e contratualização: indicador 443 (índice de acompanhamento adequado em saúde infantil no 2º ano de vida [homepage]. Lisboa: Ministério da Saúde; 2022 [cited 2021 Dec 1]. Available from: https://sdm.min-saude.pt/BI.aspx?id=443&clusters=S
Direção-Geral da Saúde. Programa nacional de vacinação 2020: norma nº 018/2020, de 27/09/2020. Lisboa: DGS; 2020.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Portuguese Journal of Family Medicine and General Practice
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The authors will assign to the RPMGF the sole right to publish and distribute the content of the manuscript specified in this declaration via physical, electronic, broadcasting or any other medium that may come into existence. They also grant the RPMGF the right to use and exploit this manuscript, in particular by assigning, selling or licensing its content. This permission is permanent and takes effect from the moment the manuscript is submitted, has the maximum duration allowed by applicable Portuguese or international law and is of worldwide scope. The authors further declare that this assignment is made free of charge. If the RPMGF informs the authors that it is not going to publish their manuscript, the exclusive assignment of rights ceases forthwith.
The authors authorise the RPMGF (or any entity it may appoint) to act on their behalf when it believes that copyright may have been infringed.
