Services on Demand
Cadernos de Saúde Pública
On-line version ISSN 1678-4464Print version ISSN 0102-311X
CESAR, Juraci A.; CAVALETI, Marcelo A.; HOLTHAUSEN, Ricardo S. and LIMA, Luis Gustavo S. de. Changes in child health indicators in a municipality with community health workers: the case of Itapirapuã Paulista, Vale do Ribeira, São Paulo State, Brazil. Cad. Saúde Pública [online]. 2002, vol.18, n.6, pp.1647-1654. ISSN 1678-4464. http://dx.doi.org/10.1590/S0102-311X2002000600019.
Twelve community health workers (CHWs) were trained to offer basic health care for children under five years of age through household visits in Itapirapuã Paulista, a municipality in Vale do Ribeira, São Paulo State, Brazil. Their tasks included diagnosis, initial treatment, and management of diarrhea and acute respiratory diseases at the household level, growth monitoring, incentives to complete basic immunization, and counseling on infant food supplementation. An average of 409 (396-417) children were visited weekly by CHWs in their homes over the course of three years. In this period, the hospitalization rate dropped drastically, and the use of oral rehydration therapy during bouts of diarrhea increased greatly. However, prevalence of stunting and incidence of low birth weight did not change. Child health indicators (CHI) in this municipality were better than those in a municipality chosen as a control. CHWs may have contributed to improved local CHI, but the results should be interpreted with caution for two reasons: (1) CHI is improving in Brazil countrywide and (2) it is a small program implemented in an area with high morbidity and mortality rates and low availability of health services.
Keywords : Health Status Indicators; Community Health Agent; Health Services; Child Health.