INTRODUÇÃO: No município de Sobral, para a década de 2000, ao mesmo tempo em que foram implantadas políticas para redução da mortalidade infantil, tiveram início as discussões sobre as condições de saúde, educação e qualidade de vida das crianças de 5 a 9 anos de idade, uma faixa etária considerada de menor vulnerabilidade do ponto de vista da saúde, mas de grande importância para a formação de hábitos saudáveis e para o desenvolvimento da criança. OBJETIVO: Nessa perspectiva, criou-se uma coorte de crianças de 5 a 9 anos de idade residentes na zona urbana do município, com o objetivo de estudar as condições de saúde, educação e qualidade de vida, fundamentais para o futuro delas, à luz dos Determinantes Sociais em Saúde. MÉTODOS: Este é um estudo de corte transversal de uma coorte de crianças nascidas nos anos de 1990 a 1994, com entrevistas domiciliares, avaliação clínica e exames laboratoriais. A estrutura do desenvolvimento da pesquisa foi elaborada tendo como base o modelo de atenção à saúde da Estratégia de Saúde da Família. No presente relato são apresentados resultados das entrevistas domiciliares quanto às condições sociodemográficas e ambientais em geral, com análise mais detalhada dos estilos de vida, escolaridade, trabalho infantil, nutrição e consumo de serviços de saúde das crianças.

INTRODUCTION: In the district of Sobral, for the decade of 2000 at the same time that political measures were implanted towards the decrease of children mortality, discussions have begun about health and educations conditions, as well as life quality of children aged between 5 and 9, which is an age group of lesser vulnerability as far as health goes, although of major importance in the development of healthy habits and for the child's development itself. OBJECTIVE: Based on such scenario, it was set up a cohort of children aged between 5 and 9 and residents of the urban area of the district in order to study health and education conditions and quality of life which are essential for the future of these children in light of the Social Determinants of Health. METHODS: This is a cross-sectional study with a cohort of children born from 1990 to 1994, home interviews, clinical evaluation and lab exams. The structure for the development of the research was elaborated based on the model of attention towards the health of Family Health Strategy. In this report, the results of such home interviews shall be presented in regards to socio-demographic and environmental conditions in general, with a more detailed analysis of life styles, educational levels, child labor, nutrition and the use of health services by children.

INTRODUÇÃO: O sistema de saúde deve ser capaz de reduzir a desigualdade no acesso aos serviços através de estratégias que alcancem aqueles que têm mais necessidade e não conseguem chegar até eles. OBJETIVO: Identificar os fatores associados à utilização dos serviços de saúde entre crianças de 5 a 9 anos do município de Sobral (CE). RESULTADOS: Apenas 558 (17,0%) crianças utilizaram os serviços de saúde no mês anterior à entrevista. A ocorrência de problemas de saúde (OR = 3,90), a utilização frequente da Estratégia Saúde da Família (ESF) (OR=1,81) e o fato de residir na sede do município (OR = 1,51) aumentaram a chance de utilização. Quase 80% utilizam a ESF como serviço de referência. As crianças de famílias mais pobres e com melhores condições de acesso tiveram mais chance de utilização da ESF. CONCLUSÃO: Os resultados do estudo sugerem que o acesso aos serviços de saúde ocorrem de forma relativamente equitativa graças à definição da ESF como porta de entrada para o sistema público de saúde do município.

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

INTRODUCTION: The profile of child morbidity is an important parameter for defining and altering health policies. Studies about infant mortality are more numerous than those on morbidity, especially related to hospital admissions. The objective of this study is to describe the causes of admission in the public health system for children from zero to nine years of age in the city of São Paulo during the years 2002 to 2006 and compare these results to those from the national data. METHOD: Through a cross-sectional study, data were obtained from the Hospital Information System, which is available in the Information System of the Unified Health System - DATASUS. RESULTS: Within the period, 16% of the total admissions corresponded to children from zero to nine years of age, with most of the children being younger than one year of age. In the city of São Paulo, the admission coefficient increased 11%, and in Brazil, it decreased 14%. Respiratory diseases were the main causes of hospitalization. In São Paulo, the second most frequent causes of admission were diseases that originated during the perinatal period (15.9%), and in Brazil, the second most frequent cause of admission was infectious-parasitic diseases (21.7%). Admissions for perinatal diseases increased 32% in São Paulo and 6% in Brazil. While hospitalizations for diarrhea decreased in Brazil, an increase was recorded in the city of São Paulo for children under five years old. CONCLUSIONS: The findings of this study show a paradoxical increase in the number of hospitalizations during an expansion of primary attention, indicating that the rise was not associated with a significant improvement in the quality of service.