Resumo Objetivo Comparar o desempenho das equipes de saúde bucal (ESBs) das modalidades I e II no processo de trabalho e as diferenças entre regiões brasileiras. Métodos Estudo transversal, com dados das ESBs que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (2013-2014). A análise de classes latentes identificou subgrupos de ESBs segundo desempenho (consolidado, em desenvolvimento ou incipiente) no processo de trabalho (planejamento das ações; promoção da saúde; atenção integral). Comparadas as modalidades, obteve-se o índice de disparidade. Resultados Avaliadas 15.886 ESBs, as da modalidade II apresentaram maior percentual de processo de trabalho consolidado nas regiões Sudeste (67,8 a 94,6%) e Sul (54,8 a 93,0%); observou-se maior disparidade no processo de trabalho consolidado entre ESBs da modalidade II (6,3 a 26,5), comparadas à modalidade I (3,9 a 18,4). Conclusão ESBs da modalidade II guardam potencial para melhor desempenho no processo de trabalho, com disparidades regionais.

Abstract Objective To compare Modality I and Modality II Oral Health Teams (OHT) regarding work process performance and differences between Brazilian regions. Methods This was a cross-sectional study with OHTs that took part in the National Program for Primary Health Care Access and Quality Improvement (2013-2014). Latent Class Analysis identified OHT subgroups according to work process (action planning, health promotion actions and comprehensive health care) performance (consolidated, developing or incipient). OHT modalities were compared, resulting in an Index of Disparity. Results After evaluating 15,886 OHTs, Modality II OHTs were found to have a higher percentage of consolidated work processes in the Southeast (67.8%-94.6%) and Southern (54.8%-93.0%) regions. Disparity in the consolidated work process was greater among Modality II OHTs (6.3-26.5) compared to Modality I OHTs (3.9-18.4). Conclusion Modality II OHTs have the potential for better performance regarding the work process, but with regional disparities.

Resumen Objetivo Comparar Equipos de Salud Bucal (ESB) modalidades I y II cuanto al desempeño en el proceso de trabajo y diferencias entre regiones brasileñas. Métodos Estudio transversal con datos de la ESB adherida al Programa Nacional de Mejoramiento del Acceso y la Calidad en Atención Primaria (2013-2014). Análisis de Clases Latentes identificaron subgrupos de ESB según el desempeño (consolidado, en desarrollo o incipiente) en el proceso de trabajo (planificación de acciones, promoción de salud y atención integral). Se compararon las modalidades y se obtuvo el Índice de Disparidad. Resultados Participaron 15.886 ESBs, las de modalidad II presentaron mayor porcentaje de proceso de trabajo consolidado en la región Sudeste (67,8% a 94,6%) y Sur (54,8% a 93,0%). La disparidad fue mayor entre la modalidad II (6,3 a 26,5) en comparación con la I (3,9 a 18,4). Conclusión las ESBs modalidad II tienen potencial para obtener mejor desempeño en el proceso de trabajo, pero hubo disparidad regional.

Resumo Objetivo Comparar o desempenho das equipes de saúde bucal (ESBs) das modalidades I e II no processo de trabalho e as diferenças entre regiões brasileiras. Métodos Estudo transversal, com dados das ESBs que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (2013-2014). A análise de classes latentes identificou subgrupos de ESBs segundo desempenho (consolidado, em desenvolvimento ou incipiente) no processo de trabalho (planejamento das ações; promoção da saúde; atenção integral). Comparadas as modalidades, obteve-se o índice de disparidade. Resultados Avaliadas 15.886 ESBs, as da modalidade II apresentaram maior percentual de processo de trabalho consolidado nas regiões Sudeste (67,8 a 94,6%) e Sul (54,8 a 93,0%); observou-se maior disparidade no processo de trabalho consolidado entre ESBs da modalidade II (6,3 a 26,5), comparadas à modalidade I (3,9 a 18,4). Conclusão ESBs da modalidade II guardam potencial para melhor desempenho no processo de trabalho, com disparidades regionais.

Abstract Objective To compare Modality I and Modality II Oral Health Teams (OHT) regarding work process performance and differences between Brazilian regions. Methods This was a cross-sectional study with OHTs that took part in the National Program for Primary Health Care Access and Quality Improvement (2013-2014). Latent Class Analysis identified OHT subgroups according to work process (action planning, health promotion actions and comprehensive health care) performance (consolidated, developing or incipient). OHT modalities were compared, resulting in an Index of Disparity. Results After evaluating 15,886 OHTs, Modality II OHTs were found to have a higher percentage of consolidated work processes in the Southeast (67.8%-94.6%) and Southern (54.8%-93.0%) regions. Disparity in the consolidated work process was greater among Modality II OHTs (6.3-26.5) compared to Modality I OHTs (3.9-18.4). Conclusion Modality II OHTs have the potential for better performance regarding the work process, but with regional disparities.

Resumen Objetivo Comparar Equipos de Salud Bucal (ESB) modalidades I y II cuanto al desempeño en el proceso de trabajo y diferencias entre regiones brasileñas. Métodos Estudio transversal con datos de la ESB adherida al Programa Nacional de Mejoramiento del Acceso y la Calidad en Atención Primaria (2013-2014). Análisis de Clases Latentes identificaron subgrupos de ESB según el desempeño (consolidado, en desarrollo o incipiente) en el proceso de trabajo (planificación de acciones, promoción de salud y atención integral). Se compararon las modalidades y se obtuvo el Índice de Disparidad. Resultados Participaron 15.886 ESBs, las de modalidad II presentaron mayor porcentaje de proceso de trabajo consolidado en la región Sudeste (67,8% a 94,6%) y Sur (54,8% a 93,0%). La disparidad fue mayor entre la modalidad II (6,3 a 26,5) en comparación con la I (3,9 a 18,4). Conclusión las ESBs modalidad II tienen potencial para obtener mejor desempeño en el proceso de trabajo, pero hubo disparidad regional.

ABSTRACT OBJECTIVE: To evaluate the annual variation of oral health and primary care coverage, the tooth extraction ratio, and the average of supervised toothbrushing in Brazilian municipalities according to social development and population size. METHODS: Public secondary data were analyzed. The outcomes were health service indicators (oral health coverage, primary health care coverage, tooth extraction ratio, and average of supervised tooth brushing) estimated for all Brazilian municipalities annually from 2008 to 2015. Mixed-effect multilevel regression models with random intercept and slopes were fitted with a cross-interaction term to estimate the annual percent variation according to the Municipal Human Development Index (MHDI) and population size. RESULTS: Municipalities with low MHDI presented an annual increase in oral health and primary care coverage of 2.65% and 2.23%, respectively, which was significantly higher than municipalities with medium and high MHDI. Oral health and primary care coverage were 69.26% and 35.00% lower among municipalities with a large population. Municipalities with medium and high MHDI showed an annual decrease in tooth extractions of 5.15% and 5.02%, respectively. An annual decrease was observed in the average of supervised toothbrushing of 9.81% and 4.57% in municipalities with low and medium MHDI, respectively. The tooth extraction ratio was higher among larger municipalities; the relation is inverse for supervised toothbrushing. CONCLUSIONS: The access to primary care and oral health services increased in Brazil, while a decrease occurred in mutilating treatment and provision of preventive actions, with disparities among municipalities with different MHDI levels over time.

ABSTRACT OBJECTIVE: To evaluate the annual variation of oral health and primary care coverage, the tooth extraction ratio, and the average of supervised toothbrushing in Brazilian municipalities according to social development and population size. METHODS: Public secondary data were analyzed. The outcomes were health service indicators (oral health coverage, primary health care coverage, tooth extraction ratio, and average of supervised tooth brushing) estimated for all Brazilian municipalities annually from 2008 to 2015. Mixed-effect multilevel regression models with random intercept and slopes were fitted with a cross-interaction term to estimate the annual percent variation according to the Municipal Human Development Index (MHDI) and population size. RESULTS: Municipalities with low MHDI presented an annual increase in oral health and primary care coverage of 2.65% and 2.23%, respectively, which was significantly higher than municipalities with medium and high MHDI. Oral health and primary care coverage were 69.26% and 35.00% lower among municipalities with a large population. Municipalities with medium and high MHDI showed an annual decrease in tooth extractions of 5.15% and 5.02%, respectively. An annual decrease was observed in the average of supervised toothbrushing of 9.81% and 4.57% in municipalities with low and medium MHDI, respectively. The tooth extraction ratio was higher among larger municipalities; the relation is inverse for supervised toothbrushing. CONCLUSIONS: The access to primary care and oral health services increased in Brazil, while a decrease occurred in mutilating treatment and provision of preventive actions, with disparities among municipalities with different MHDI levels over time.

Objective: To compare the Oral Health Teams (OHT) modalities I and II regarding performance in the work process and differences between Brazilian regions. Methods: Cross-sectional study with data from the OHT that joined to the National Program for Improving Access and Quality in Primary Care (2013/2014). Latent Class Analysis identified subgroups of OHT according to performance (consolidated, developing or incipient) in the work process (action planning, health promotion actions and integral health care). OHT modalities were compared and the Disparity Index was obtained. Results: 15,886 OHT participated. OHT modality II showed a higher percentage of consolidated work process in Southeast (67.8% to 94.6%) and South (54.8% to 93.0%) regions. Disparity in the consolidated work process was greater between OHT modality II (6.3 a 26.5) compared to I (3.9 a 18.4). Conclusion: OHT modality II has the potential to obtain better performance regarding the work process, but there was a regional disparity.

Objetivo: Comparar o desempenho das equipes de saúde bucal (ESB) das modalidades I e II no processo de trabalho e diferenças entre regiões brasileiras. Métodos: Estudo transversal, com dados das ESBs que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (2013/2014). A análise de classes latentes identificou subgrupos de ESBs segundo desempenho (consolidado, em desenvolvimento ou incipiente) no processo de trabalho (planejamento das ações; promoção da saúde; atenção integral). Comparadas as modalidades, obteve-se o índice de disparidade. Resultados: Avaliadas 15.886 ESBs, as da modalidade II apresentaram maior percentual de processo de trabalho consolidado nas regiões Sudeste (67,8 a 94,6%) e Sul (54,8 a 93,0%); observou-se maior disparidade no processo de trabalho consolidado entre ESBs da modalidade II (6,3 a 26,5), comparadas à modalidade I (3,9 a 18,4). Conclusão: ESBs da modalidade II guardam potencial para melhor desempenho no processo de trabalho, com disparidades regionais.

Resumo Objetivou-se avaliar o preenchimento da Caderneta de Saúde da Criança (CSC) e a associação entre qualidade do preenchimento e o tipo de serviço usado para o acompanhamento da saúde das crianças. Estudo transversal com amostra estratificada e proporcional aos 9 Distritos Sanitários de Belo Horizonte, selecionada entre crianças de 3 a 5 anos, no Dia da Campanha de Vacinação Infantil 2014. Realizou-se entrevista com os pais e observação de 21 itens da CSC. A variável dependente foi definida pela qualidade (satisfatória/insatisfatória) do preenchimento da CSC, sendo considerado satisfatório o preenchimento > 60%. As variáveis independentes foram o tipo de serviço para acompanhamento da saúde da criança, características demográficas e condições de saúde da mãe e da criança, e atenção em saúde recebida pela criança. Participaram 367 pais. A proporção de preenchimento insatisfatório foi 55,5%. Não houve associação significativa entre qualidade de preenchimento e tipo de serviço de saúde. O preenchimento insatisfatório esteve associado à idade gestacional < 37 semanas, falta de acesso a informações sobre a CSC e ausência de anotações dos pais na CSC. A CSC tem sido insatisfatoriamente empregada como um instrumento de vigilância da saúde independentemente do tipo de serviço usado pela criança.

Abstract The scope of this study was to assess the way Child Health Records (CHRs) are filled out and the association between the quality of entries and type of service used to monitor the health of children. It involved a cross-sectional study with a stratified sample – proportional for the nine Health Districts of Belo Horizonte, State of Minas Gerais – of 3- to 5-year-old children selected on Child Vaccination Campaign Day in 2014. Interviews with parents including observation of the 21 CHR items were conducted. The dependent variable was defined by the quality of the CHR entry (satisfactory/unsatisfactory), where satisfactory entries were > 60%. The independent variables were the type of service for monitoring child health, demographic and health conditions of the mother and child and healthcare treatment received by the child, with the participation of 367 (96.10%) parents. The prevalence of unsatisfactory entries was 55.5%. No significant association was found between quality of entry and type of healthcare. Unsatisfactory entries were associated with gestational age < 37 weeks, lack of access to information about the CHR and the absence of parental entries on the CHR. The CHR has been unsatisfactorily employed as a tool for monitoring health, irrespective of the type of service used by the child.

Resumo Objetivou-se avaliar o preenchimento da Caderneta de Saúde da Criança (CSC) e a associação entre qualidade do preenchimento e o tipo de serviço usado para o acompanhamento da saúde das crianças. Estudo transversal com amostra estratificada e proporcional aos 9 Distritos Sanitários de Belo Horizonte, selecionada entre crianças de 3 a 5 anos, no Dia da Campanha de Vacinação Infantil 2014. Realizou-se entrevista com os pais e observação de 21 itens da CSC. A variável dependente foi definida pela qualidade (satisfatória/insatisfatória) do preenchimento da CSC, sendo considerado satisfatório o preenchimento > 60%. As variáveis independentes foram o tipo de serviço para acompanhamento da saúde da criança, características demográficas e condições de saúde da mãe e da criança, e atenção em saúde recebida pela criança. Participaram 367 pais. A proporção de preenchimento insatisfatório foi 55,5%. Não houve associação significativa entre qualidade de preenchimento e tipo de serviço de saúde. O preenchimento insatisfatório esteve associado à idade gestacional < 37 semanas, falta de acesso a informações sobre a CSC e ausência de anotações dos pais na CSC. A CSC tem sido insatisfatoriamente empregada como um instrumento de vigilância da saúde independentemente do tipo de serviço usado pela criança.

Abstract The scope of this study was to assess the way Child Health Records (CHRs) are filled out and the association between the quality of entries and type of service used to monitor the health of children. It involved a cross-sectional study with a stratified sample – proportional for the nine Health Districts of Belo Horizonte, State of Minas Gerais – of 3- to 5-year-old children selected on Child Vaccination Campaign Day in 2014. Interviews with parents including observation of the 21 CHR items were conducted. The dependent variable was defined by the quality of the CHR entry (satisfactory/unsatisfactory), where satisfactory entries were > 60%. The independent variables were the type of service for monitoring child health, demographic and health conditions of the mother and child and healthcare treatment received by the child, with the participation of 367 (96.10%) parents. The prevalence of unsatisfactory entries was 55.5%. No significant association was found between quality of entry and type of healthcare. Unsatisfactory entries were associated with gestational age < 37 weeks, lack of access to information about the CHR and the absence of parental entries on the CHR. The CHR has been unsatisfactorily employed as a tool for monitoring health, irrespective of the type of service used by the child.

Resumo Objetivo: descrever o preenchimento da Caderneta de Saúde da Criança (CSC) nos serviços de saúde. MÉTODOS: estudo descritivo, desenvolvido em Belo Horizonte, Minas Gerais, Brasil; realizou-se entrevista com os pais/responsáveis de crianças de 3 a 5 anos de idade e observaram-se 21 itens essenciais ao acompanhamento infantil na CSC, no Dia de Multivacinação de 2014; considerou-se separadamente os campos a serem preenchidos nas maternidades e na Atenção Primária à Saúde (APS) e outros serviços. Resultados: foram incluídas 367 crianças (96,1%); 44,5% das CSC apresentaram ≥60% dos itens preenchidos; dos itens a serem registrados nas maternidades, o peso ao nascer apresentou maior proporção de preenchimento (64,5%); daqueles a serem registrados na APS e outros serviços, os campos das vacinas foram os mais preenchidos (94,0%); houve maior preenchimento na maternidade do que na APS e outros serviços (p<0,001). Conclusão: observou-se baixa proporção de preenchimento, especialmente na APS e outros serviços.

Abstract Objective: to describe the filling process of the Child Health Record (CHR) in health care services. Methods: descriptive study held in Belo Horizonte, Minas Gerais, Brazil; an interview was conducted with parents/guardians of children aged 3-5 years old; 21 essential items to child monitoring were observed in the CHR during the 2014 Multi-vaccination Day; fields that should be filled in maternity wards, Primary Health Care (PHC), and other services were assessed separately. Results: 367 children (96.1%) were included; 44.5% of CHR presented ≥60% of completeness; among the items that should be recorded in maternity wards, birth weight showed the highest proportion of completeness (64.5%); for those that should be filled in PHC/other services, records of vaccines (94.0%) presented the highest completeness; there was more filling in maternity wards than in PHC and other services (p<0.001). Conclusion: a low proportion of filling was observed, especially in PHC and other services.

Resumen Objetivo: describir el llenado del Libro de Salud del Niño (LSN) en los servicios de salud. Métodos: estudio descriptivo con niños de 3 a 5 años de Belo Horizonte, Minas Gerais, Brasil; se entrevistó a los padres y fueron analizados 21 partes esenciales del acompañamiento infantil en la LSN, en el Día de Multivacunación de 2014; se consideró por separado los campos que debían ser llenados en las maternidades y en la Atención Primaria de Salud (APS)/otros servicios. Resultados: se incluyeron 367 niños (96,1%); 44,5% del LSN presentaron ≥60% de las partes llenadas; en las maternidades, el peso al nacer presentó mayor proporción de llenado (64,5%); ya en las APS/otros el registro de vacunas fue el mayor (94,0%); el llenado fue mayor en maternidades que en las APS y otros servicios (p<0,001). Conclusión: se observó baja proporción de llenado, especialmente en los servicios de APS y otros.

Resumo Objetivo: descrever o preenchimento da Caderneta de Saúde da Criança (CSC) nos serviços de saúde. MÉTODOS: estudo descritivo, desenvolvido em Belo Horizonte, Minas Gerais, Brasil; realizou-se entrevista com os pais/responsáveis de crianças de 3 a 5 anos de idade e observaram-se 21 itens essenciais ao acompanhamento infantil na CSC, no Dia de Multivacinação de 2014; considerou-se separadamente os campos a serem preenchidos nas maternidades e na Atenção Primária à Saúde (APS) e outros serviços. Resultados: foram incluídas 367 crianças (96,1%); 44,5% das CSC apresentaram ≥60% dos itens preenchidos; dos itens a serem registrados nas maternidades, o peso ao nascer apresentou maior proporção de preenchimento (64,5%); daqueles a serem registrados na APS e outros serviços, os campos das vacinas foram os mais preenchidos (94,0%); houve maior preenchimento na maternidade do que na APS e outros serviços (p<0,001). Conclusão: observou-se baixa proporção de preenchimento, especialmente na APS e outros serviços.

Abstract Objective: to describe the filling process of the Child Health Record (CHR) in health care services. Methods: descriptive study held in Belo Horizonte, Minas Gerais, Brazil; an interview was conducted with parents/guardians of children aged 3-5 years old; 21 essential items to child monitoring were observed in the CHR during the 2014 Multi-vaccination Day; fields that should be filled in maternity wards, Primary Health Care (PHC), and other services were assessed separately. Results: 367 children (96.1%) were included; 44.5% of CHR presented ≥60% of completeness; among the items that should be recorded in maternity wards, birth weight showed the highest proportion of completeness (64.5%); for those that should be filled in PHC/other services, records of vaccines (94.0%) presented the highest completeness; there was more filling in maternity wards than in PHC and other services (p<0.001). Conclusion: a low proportion of filling was observed, especially in PHC and other services.

Resumen Objetivo: describir el llenado del Libro de Salud del Niño (LSN) en los servicios de salud. Métodos: estudio descriptivo con niños de 3 a 5 años de Belo Horizonte, Minas Gerais, Brasil; se entrevistó a los padres y fueron analizados 21 partes esenciales del acompañamiento infantil en la LSN, en el Día de Multivacunación de 2014; se consideró por separado los campos que debían ser llenados en las maternidades y en la Atención Primaria de Salud (APS)/otros servicios. Resultados: se incluyeron 367 niños (96,1%); 44,5% del LSN presentaron ≥60% de las partes llenadas; en las maternidades, el peso al nacer presentó mayor proporción de llenado (64,5%); ya en las APS/otros el registro de vacunas fue el mayor (94,0%); el llenado fue mayor en maternidades que en las APS y otros servicios (p<0,001). Conclusión: se observó baja proporción de llenado, especialmente en los servicios de APS y otros.