scholarly journals Understanding how low-income communities gain access to healthcare services: A qualitative study in São Paulo, Brazil

2019 ◽  
Vol 15 ◽  
pp. 100658 ◽  
Author(s):  
Thiago Guimarães ◽  
Karen Lucas ◽  
Paul Timms
2011 ◽  
Vol 24 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Itamar S. Santos ◽  
Márcia Scazufca ◽  
Paulo A. Lotufo ◽  
Paulo R. Menezes ◽  
Isabela M. Benseñor

ABSTRACTBackground: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the São Paulo Ageing & Health Study to address the relationship between anemia and dementia.Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, São Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively.Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17–3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76–2.33, p = 0.32). Further multivariate adjustment did not change the results.Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from São Paulo.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256092
Author(s):  
Tatiane Fernandes Novaes ◽  
Maisa Camillo Jordão ◽  
Carlos Felipe Bonacina ◽  
André Oswaldo Veronezi ◽  
Carlos Ariel Rodrigues de Araujo ◽  
...  

The state of São Paulo, Brazil, where more than 94.000 dentists are currently registered, has become the epicenter of COVID-19 in Latin America. The aim of this cross-sectional study was to evaluate the impact of COVID-19 pandemic on dentists in this state. A semi-structured questionnaire was sent via e-mail to 93.280 dentists with active registration in the Dental Council of São Paulo (CROSP). The impact of COVID-19 pandemic was assessed through questions related to demographic, socioeconomic, dental practice characteristics and personal protective equipment (PPE) use. Ordinal logistic regression analysis was performed to investigate the association between all the variables (p<0.05). Over 8 days, 2113 responses were received. Only 26.52% of the sample reported a low-income reduction (from 0–10%), while the majority of dentists reported a more negative financial impact, 35.6% with a reduction of more than 50% of their monthly income. Dentists who worked in the private sector and at the capital had a greater financial impact when compared to those of the public sector and countryside of the state (p<0.05). Furthermore, about 83% reported not having received any specific training to control the transmission of coronavirus in the health area. This study provides evidence of the negative impact of the COVID-19 pandemic on the routine of dentists in the state of São Paulo, Brazil. Hopefully, this study will help dental and other health care professionals to better understand the consequences of disease in dental settings and strengthen preparedness throughout the dental health care system.


2020 ◽  
Author(s):  
Giuliano Russo ◽  
Maria Luiza Levi Paim ◽  
Maria Teresa Seabra Soares de Britto e Alves ◽  
Bruno Luciano Carneiro Alves de Oliveira ◽  
Ruth Helena de Souza Britto Ferreira de Carvalho ◽  
...  

Background. Economic recessions carry an impact on population health and access to care; less is known on how health systems adapt to the conditions brought by a downturn. This particularly matters now that the COVID-19 epidemic is putting health systems under stress. Brazil is one of the world’s most affected countries, and its health system was already living the aftermath of the 2015 recession. Methods. Between 2018 and 2019 we conducted 46 semi-structured interviews with health practitioners, managers and policy-makers to explore the impact of the 2015 recession on public and private providers in prosperous (São Paulo) and impoverished (Maranhão) states in Brazil. Thematic analysis was employed to identify drivers and consequences of system adaptation and coping strategies. Nvivo software was used to aid data collection and analysis. We followed the Standards for Reporting Qualitative Research to provide an account of the findings.Results. We found the concept of ‘health sector crisis’ to be politically charged among healthcare providers in São Paulo and Maranhão. Contrary to expectations, the public sector was reported to have found ways to compensate for diminishing federal funding, having outsourced services and adopted flexible – if insecure – working arrangements. Following a drop in employment and health plans, private health insurance companies streamlined their offer, at times at the expenses of coverage. Low-cost walk-in clinics were hit hard by the recession, but also credited for having moved to cater for higher-income customers in Maranhão.Conclusions. The ‘plates’ of a health system may shift and adjust in unexpected ways in response to recessions, and some of these changes might outlast the crisis. As low-income countries enter post-COVID recessions, it will be important to monitor the adjustments taking place in health systems, to ensure that past gains in access to care and job security are not eroded.


2012 ◽  
Vol 15 (2) ◽  
pp. 135-138 ◽  
Author(s):  
Hsiang Huang ◽  
Alexandre Faisal-Cury ◽  
Ya-Fen Chan ◽  
Karen Tabb ◽  
Wayne Katon ◽  
...  

2022 ◽  
pp. 0739456X2110654
Author(s):  
Kristine Stiphany ◽  
Peter M. Ward ◽  
Leticia Palazzi Perez

Rental housing was historically a minimal feature of urban informality. Now it is surging amid municipal attempts to “upgrade” informal settlements in São Paulo, Brazil. Drawing upon a mixed-methodological study of two favelas on São Paulo’s east side, we analyze how cycles of upgrading shape informal rental housing at the urban, community, block, and parcel levels, providing detailed comparative data for 2010–2020. Our findings suggest that rental housing redevelopment can increase precarity in urban living, but is an important source of low-income housing in already built-up and “consolidated” settlements where access is declining. Our study emphasizes the need for scholars, policy makers, and planners to further explore the praxis of informal renting and rental housing, which can be effective conduits for channeling public investments across consolidated informal settlements and into individual dwellings.


Cephalalgia ◽  
2008 ◽  
Vol 28 (4) ◽  
pp. 329-333 ◽  
Author(s):  
IM Benseñor ◽  
PA Lotufo ◽  
AC Goulart ◽  
PR Menezes ◽  
M Scazufca

There are scarce data about headache prevalence and its characteristics among elderly people. The aim was to carry out a cross-sectional study to determine the 1-year prevalence of tension-type and migraine headaches in people >65 years old in the city of São Paulo, Brazil. All 1615 people living in the study catchment area who agreed to participate in the study answered a questionnaire based in the International Headache Society criteria. Prevalence (mean and 95% confidence interval) of any type of headache in the last year was 45.6% (43.2, 48.0). Prevalence of tension-type headache in the last year was 33.1% (30.8, 35.4): 28.1% (24.6, 31.6) for men and 36.4% (33.4, 39.4) for women; for migraine headaches, prevalence in the last year was 10.6% (9.1, 12.1): 5.1% (3.4, 6.8) for men and 14.1% (11.9, 16.3) for women. One-year prevalence rates of headaches, and especially of migraine headaches, are very high among the elderly in Brazil.


2010 ◽  
Vol 26 (11) ◽  
pp. 2059-2067 ◽  
Author(s):  
Marly Augusto Cardoso ◽  
Luciana Yuki Tomita ◽  
Elaine Cristina Laguna

This study describes the validity of a food frequency questionnaire (FFQ) in 93 low-income women (20-65 years), participating in a case-control study in São Paulo, Brazil. Two FFQ (FFQ1 and FFQ2, 12 months apart) and three 24-hour dietary recalls (24hR) were conducted between 2003 and 2004 to estimate dietary intake during the past year. The Pearson correlation coefficients (crude, energy-adjusted and de-attenuated) were used for comparisons between FFQ and 24hR. The agreement between the methods was further examined by the Bland-Altman analysis. For the assessment of long-term reliability, the energy-adjusted intra-class correlation coefficients were mostly around 0.40, but higher for vitamin A and folate (0.50-0.56). Energy-adjusted, attenuation-corrected Pearson validity correlations between FFQ and DR ranged from 0.30-0.54 for macronutrients to 0.20-0.48 for micronutrients, with higher value for calcium (0.75). There were small proportions of grossly misclassified nutrient intakes, while Bland-Altman plots indicated that the FFQ is accurate in assessing nutrient intake at a group level.


2019 ◽  
Vol 27 ◽  
pp. e36678
Author(s):  
Edgar Amatuzzi ◽  
Marcela Astolphi Souza ◽  
Luciana De Lione Melo

Objetivo: compreender as vivências de famílias de crianças em período intraoperatório, participantes de oficina de biscuit. Método: pesquisa qualitativa, modalidade fenomenológica, realizada em um hospital público, de ensino, localizado no estado de São Paulo, com 13 famílias de crianças em período intraoperatório, após aprovação do comitê de ética, parecer número 2253964. Resultados: as famílias revelaram que o período intraoperatório é o mais crítico, repleto de expectativas sobre o sucesso e/ou insucesso da cirurgia. No entanto, ao participarem da oficina de biscuit, as famílias perceberam novos sentimentos, como calma, tranquilidade, relaxamento, distração e troca de experiências entre as famílias. O uso da arte foi considerado um modo de cuidado à família e seu reconhecimento mobilizou sentimento de gratidão nessas famílias. Conclusão: a oficina de biscuit possibilitou a manifestação de sentimentos positivos, além do reconhecimento desta intervenção como sendo um modo de cuidado à família.ABSTRACTObjective: to understand the experiences of the families of children in the intraoperative period, who were participating in a cold porcelain workshop. Methodology: this phenomenological, qualitative study was conducted at a public teaching hospital in São Paulo state with 13 families of children in the intraoperative period, after research ethics committee approval (Opinion No. 2253964). Results: the families revealed that the intraoperative period is the most critical, and full of expectations about the success and/or failure of surgery. However, by participating in the cold porcelain workshop, the families perceived new feelings of calm, tranquility, relaxation, distraction and sharing of experiences among families. Using art was considered a way of caring for the family, and recognition of that brought out a feeling of gratitude in these families. Conclusion: the cold porcelain workshop allowed people to express good feelings, as well as the acknowledgement that this was a way of caring for the family.RESUMENObjetivo: comprender las vivencias de familias de niños en periodo intraoperatorio, participantes de taller de biscuit. Metodología: investigación cualitativa, modalidad fenomenológica, realizada en un hospital público, de enseñanza, localizado en el estado de São Paulo, con 13 familias de niños en periodo intraoperatorio, después de aprobación del comité de ética, dictamen número 2253964. Resultados: las familias revelaron que el periodo intraoperatorio es el más crítico, repleto de expectativas sobre el éxito y/o fracaso de la cirugía. Sin embargo, al participar del taller de biscuit, las familias percibieron nuevos sentimientos, como calma, tranquilidad, relajación, distracción e intercambio de experiencias entre las familias. El uso del arte fue considerado un modo de cuidado a la familia y su reconocimiento ocasionó un sentimiento de gratitud en esas familias. Conclusión: el taller de biscuit posibilitó la manifestación de sentimientos positivos, además del reconocimiento de esta intervención como siendo un modo de cuidado a la familia.


Urban Studies ◽  
2016 ◽  
Vol 55 (3) ◽  
pp. 522-537 ◽  
Author(s):  
Megha Amrith

The city of São Paulo, historically important as a destination for migrants from across the world, has experienced newer waves of immigration in the past few decades. As Brazilian national legislation and municipal policies have been ill prepared to handle these recent flows, migrants find themselves without much institutional support and rely instead on other networks to find their way in the city. This article is based on ethnographic research among low-income migrants in São Paulo, many of whom are employed as tailors and garment vendors in the city’s thriving central commercial neighbourhoods. Migrants from Bolivia, Peru, China, Pakistan and Nepal co-exist alongside working-class Brazilians. This article traces the everyday forms of conviviality among these migrants who find themselves in precarious conditions in São Paulo. It will consider the lines along which friendships and networks of support and sociability are built and the depth of such relationships. It also considers the points of tension which divide people and strain potential friendships, for instance, when migrants compete to sell their goods and are exploited by ‘fellow migrants’ to survive in the city. What we see is an ambivalent field of interaction that is convivial yet competitive and distrustful.


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