Realização de atividades extraclínicas pelas equipes de saúde bucal no Brasil

Abstract

Dentists of Family Health teams should perform, support and develop activities related to oral health with the other team members. Extraclinical activity (ECA) can be considered any activity developed outside the scope of the dental clinic and which strengthens the planning and health promotion actions for the community. In this context, the objective of this study is to verify the individual and contextual factors associated with the performance of extraclinical activities by the oral health teams participating in PMAQ-AB, in Brazil in 2014. This is a multilevel cross-sectional observational study from secondary data from 18,333 oral health teams and the municipalities to which these health teams were located in Brazil in 2014. Data were collected through interviews using a structured questionnaire. The outcome used was extraclinical actions and the exposure variables were organized into three dimensions, sociodemographic contextual level, health service contextual level and individual work process level. The data were analyzed with the estatofter 14 and hierarchical modeling and poisson regression were performed to obtain the prevalence ratios. The prevalence of extraclinical actions by the oral health teams was 54.2% (95% CI: 53.5-54.9). In the adjusted analysis in relation to the contextual characteristics, the highest prevalences were found among municipalities of the city. northeastern region (RP:1.28 IC 95%: 1.16-1.41), with more than 500 thousand inhabitants (RP 1.34 IC95%: 1.15-1.57), municipalities with very high HDI (RP: 2.07 IC95%: 1.18-3.61) with oral health coverage of 50% or more (RP 1.22 IC95%: 1.14- 1.30), with proportion of tooth extraction compared to other procedures less than 8% (RP 1,08 IC95% 1,02-1,14) and with an average supervised tooth brushing of 8% or more(RP 1.11 IC95%:1.03-1.20). Regarding individual characteristics, the highest prevalences were found among the teams that performed health education (RP 2.06 IC95%: 1.78-2.38), with the presence of logitudinality of care(RP1.25 IC95%:1.12- 1.39) with participation of the complete team in the continuing education actions ( RP 1.21 95% 1.12-1.30) and receiving institutional support for planning ( RP 1.17 IC 95%: 1.09-1.25)Therefore, this evaluation contributes to the planning and monitoring of health management that through health actions and continuing education can optimize extraclinical activities, which are important for the advancement of oral health care.