O processo de notificação da violência contra crianças e adolescentes por profissionais da Estratégia Saúde da Família em Manaus - AM

Abstract

The main objective of this thesis was to analyse the process of notification, by professionals of the Family Health Strategy (ESF), of violence against children and adolescents in Manaus, Amazonas. To that end, the cases of violence against children and adolescents were characterized, the completeness of the notification forms from 2009 to 2016 was analyzed, the sociodemographic characteristics, the professional training and the degree of knowledge of the professionals of the FHS were analyzed in the profile of cases, the line of care in the health services and the system of surveillance of violence against children and adolescents and, in addition, the effect of these degrees of professionals' knowledge in case reports. In order to reach the first two objectives proposed, a descriptive study was carried out with an analysis of the fields of the notification sheets of 10,333 registered cases, during the proposed period. For the other objectives, a cross-sectional study was The main objective of this thesis was to analyze the process of notification, by professionals of the Family Health Strategy (ESF), of violence against children and adolescents in Manaus, Amazonas. carried out at the basic health units with ESF between October 2017 and April 2018. The field survey included 611 professionals from the FHS (52.5% of the eligible ones). The instrument covered modules related to sociodemographic characteristics; professional training and performance in the FHS; organization and flow of the notification process in the health service of the professional; identification and work process in dealing with violence; previous experiences with the safety net; to the knowledge and attitudes of the professional regarding the handling and reporting of cases and experiences related to violence in childhood. The first article reveals that about 69% of reported cases involving children were girls, with parents, stepfathers and stepmothers being the main perpetrators. Female adolescents were also the main victims of violence, though the friends/acquaintances were the main perpetrators. Sexual violence was the most reported in both groups. The completeness of the fields of the file ranged from 11.2% to 100.0%. The second article shows that the health professionals of the ESF in Manaus have little control over the issues related to the care line and the system of surveillance of situations of violence involving children and adolescents. The third article points out that both the degree of knowledge about the manifestations, the profile of cases, the line of care and the system of surveillance of violence are associated with the act of reporting the cases. It is hoped that the dissemination of the findings of this thesis contributes to the improvement of the process of recording the situations of violence involving children and adolescents by health professionals in basic care and of the violence surveillance system as a whole, in order to increase the coverage of the notification of cases and improve the quality of the information in the notification sheets.