Paulo de Frias

Universidade Federal de Pernambuco, Instituto De Medicina Integral Professor Fernando Figueira, Faculty Member

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Papers by Paulo de Frias

Incentivo Ao Aleitamento Materno: Uma Avaliação Das Equipes De Saúde Da Família Do Município De Olinda, Pernambuco

by Paulo Frias, Suely Vidal, and Paulo de Frias

Rev. Bras. Saude Mater. …

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Hospital Neonatal Mortality in Cohort of Newborns in a Maternity School in the Northeastern Region of Brazil, 2001-2003 Mortalidade neonatal hospitalar na coorte de nascidos vivos em maternidade-escola na Região Nordeste do Brasil, 2001-2003

by Paulo Frias, Suely Vidal, J. Figueiroa, and Paulo de Frias

Summary This study intends to describe the neonatal mortality profile among newborn babies at a t... more Summary This study intends to describe the neonatal mortality profile among newborn babies at a tertiary institution in Pernambuco State, Brazil, between 2001 and 2003, using data from live births and deaths certificates. In order to do this, a link was made between the records of the respective databases. The neonatal mortality rate was high - certainly influenced by the

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Evaluation of child mortality notifications to the Information System for Infant Deaths: a case study

by Paulo Frias, Suely Vidal, and Paulo de Frias

Revista Brasileira de Saúde Materno Infantil

OBJECTIVES: to assess infant mortality notification to the Mortality Information System (MIS) and... more OBJECTIVES: to assess infant mortality notification to the Mortality Information System (MIS) and other notification sources support in Bom Conselho, Pernambuco, PE, 1999. METHODS: case study using child mortality data from homes in Bom Conselho collected by the municipal and state databanks, complemented by an active search in civil registration offices, healthcare units, cemeteries and communities, healthcare agents and traditional midwives. Household investigations was performed for all deaths and used to validate addresses. The percentage of under-notification to the Infant Mortality Information System and deaths grouped according to information location and notifying sources was calculated. RESULTS: high under-notification rate (46%) was determined as well as a high number of deaths at home. This data is suggestive of poor access to healthcare services as one of the most important issues. The principal source for notification were the community health agents followed by civil r...

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Hypothermia on admission: a risk factor for death in newborns referred to the Pernambuco Institute of Mother and Child Health

by Paulo Frias, Suely Vidal, Paulo de Frias, and MARIA JULIA DE MELLO

Journal of Tropical Pediatrics

The objective of this study was to determine the mortality risk related to hypothermia at the mom... more The objective of this study was to determine the mortality risk related to hypothermia at the moment of admission and other factors such as clinical and geographical related to the transportation of the newborns admitted to the Instituto Materno Infantil de Pernambuco IMIP from 8 March to 11 June 2000. A prospective study involving 320 newborns arriving from home or health centres was carried out. Babies that were dead on arrival or subsequently transferred to other units were excluded. The risk of death was determined according to exposure to hypothermia and other types of exposure, using logistical regression. The risk of death was higher (RR = 3.09; CI = 2.15-4.43) in the group exposed to moderate hypothermia (temperature between 32.5 degrees C and 35.99 degrees C) than in the non-exposed group (temperature equal to or greater than 36.00 degrees C). The relative risk of death was also higher for newborns with a weight of less than 2500 g, that were less than 1 day old, respirator...

Avaliação normativa da ação programática imunização nas equipes de saúde da família do Município de Olinda, Estado de Pernambuco, Brasil, em 2003

by Daniela Santos, Suely Vidal, Paulo Frias, and Paulo de Frias

Epidemiologia e Serviços de Saúde, 2006

Este estudo visa avaliar o grau de implantação da ação programática Imunização e verificar suas a... more Este estudo visa avaliar o grau de implantação da ação programática Imunização e verificar suas atividades executadas no Município de Olinda, Estado de Pernambuco, Brasil. Realizou-se um estudo avaliativo, do tipo normativo de corte transversal, no período de junho a julho de 2003, entre as 40 equipes de saúde da família da localidade. Utilizou-se um instrumento estruturado com questões relativas aos critérios e normas preconizados pelo Programa Nacional de Imunizações do Ministério da Saúde, contemplando tanto aspectos estruturais como de processo. Detectou-se baixo grau de implantação nas equipes (100% parcialmente implantadas). As atividades encontradas com maior freqüência foram: "Disponibilidade das vacinas do esquema básico"; "Realização do esquema completo de imunização"; e "Envolvimento multiprofissional" na execução dessa ação programática (100% para todas). Os resultados indicam que as equipes não seguem as normas e rotinas preconizadas, o que demonstra a necessidade de implementação de ações de caráter político e operacional para o programa alcançar suas metas.

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Vigilância de óbitos infantis como indicador da efetividade do sistema de saúde - estudo em um município do interior do Nordeste brasileiro

by Paulo Frias, Suely Vidal, and Paulo de Frias

Jornal de Pediatria, 2002

Base de dados : LILACS. Pesquisa : 327744 [Identificador único]. Referências encontradas : 1 [ref... more

<a name="topo"></a>Avaliação da qualidade de preenchimento das declarações de óbito em unidade terciária de atenção à saúde materno-infantil

by Paulo Frias, Suely Vidal, and Paulo de Frias

Informe Epidemiológico do Sus, 2002

Informe Epidemiológico do SUS 2002; 11(1) : 7 -14. Resumo Apesar de duas décadas e meia de implan... more Informe Epidemiológico do SUS 2002; 11(1) : 7 -14. Resumo Apesar de duas décadas e meia de implantação do Sistema de Informações sobre Mortalidade (SIM) no Brasil, as estatísticas de mortalidade ainda apresentam problemas de confiabilidade, pois, mesmo em unidades de saúde de referência, existem Declarações de Óbito (DO), que apresentam distorções nos registros. O objetivo do estudo foi avaliar a qualidade da DO quanto ao grau de preenchimento das variáveis e verificar o ganho de informação pósresgate no prontuário médico em unidade de saúde terciária em Recife (Pernambuco-PE). Foram comparadas as DO originais com as corrigidas no primeiro semestre de 1999. Os resultados mostraram omissões no preenchimento das variáveis indispensáveis e essenciais entre 0,7 e 10,9%, com resgate completo de informação no prontuário. Para as variáveis exclusivas de menores de um ano, as omissões ficaram entre 27 e 47% e os ganhos de informação obtidos foram inferiores a 50%, chegando à total ausência, apesar de sua fundamental importância para análises clínico-epidemiológicas dos fatores de risco para a mortalidade infantil. As omissões no preenchimento das variáveis contidas na DO e o ganho pouco satisfatório de informações pós-resgate nos prontuários refletem o desconhecimento médico de seu papel, sendo prioritária a implementação dos núcleos de epidemiologia hospitalar, garantindo treinamento e educação continuada ao corpo clínico institucional.

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Mortalidade neonatal hospitalar na coorte de nascidos vivos em maternidade-escola na Região Nordeste do Brasil, 2001-2003

by Suely Vidal, Paulo Frias, and Paulo de Frias

… e Serviços de …, 2006

Resumo Esse estudo analisa o perfil da mortalidade neonatal dos recém-nascidos de instituição ter... more

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Aleitamento materno: avaliação da implantação do programa em unidades básicas de saúde do Recife, Pernambuco (2002)

by Paulo Frias, Suely Vidal, Paulo de Frias, and Luciana Caroline

Ciência & Saúde Coletiva, 2007

This paper analyses the implementation level of a breast-feeding incentive program at Government ... more This paper analyses the implementation level of a breast-feeding incentive program at Government healthcare facilities in Recife, Pernambuco State, Brazil, through a normative assessment conducted through 84 Family Health Teams and at 42 Health Centers in January 2002. A tool containing structured questions was used, related to rules and routines for promoting breastfeeding. The Family Health Teams performed better, with the actions implemented in 7.1% of these Teams and at none of the Health Centers; they were rated as 'not implemented' for 1.2% of the Family Health Teams and 47.6% of the Health Centers. This leads to the conclusion that implementation levels are not satisfactory, reflecting difficulties in breaking away from clinical practice and individual habits in order to introduce universal and allround health promotion measures.

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Avaliação normativa das ações do Programa de Atenção Integral à Saúde da Criança (PAISC) em Pernambuco

by Suely Vidal, Paulo Frias, and Paulo de Frias

Revista Brasileira de Saúde Materno Infantil, 2001

Objectives: A descriptive study was carried out to evaluate the implementation of the Whole Atten... more Objectives: A descriptive study was carried out to evaluate the implementation of the Whole Attention to Child Health Program (WACHP) in the state of Pernambuco, Brazil. Methods: one health unit in each of the 176 municipalities and 6 units in the capital city of the state were selected for the study. The evaluation was based on the guidelines for evaluation of health programs as recommended by the Ministry of Health. Data collection took place from October to December 1995.

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[Infant death surveillance as an indicator of health care system effectiveness--a study conducted in northeastern Brazil]

by Lygia Vanderlei, Suely Vidal, and Paulo de Frias

Jornal de pediatria

To evaluate the access to and quality of health care administered to infants based on postmortem ... more To evaluate the access to and quality of health care administered to infants based on postmortem data. A descriptive cross-sectional census-based study was carried out to assess the infant deaths that occurred in the town of Bom Conselho, state of Pernambuco, between January 1st 1999 and December 31st 1999. Home interviews and inspection of medical records were used for data collection. Deaths were identified by consulting the Mortality Information System, health centers, public notary services, cemeteries, health workers, and midwives. Seventy-one of 72 deaths were investigated, with a loss of 1.4%. The majority (69.4%) of deaths occurred in the postneonatal period and 67.6% of them occurred at home. In 77.5% of the cases medical help was sought at least once, most frequently at emergency units (65.1%). However, 22.5% of the patients were not taken to any kind of health care service. Most health care services (90.9%) were less than one hour away from the patient's home, 78.5% w...

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Avanços e desafios na saúde materna e infantil no Brasil

by Paulo de Frias and Lygia Vanderlei

Revista Brasileira de Saúde Materno Infantil, 2015

[Completeness variable evaluation from death certificate of children less than one year in Pernambuco State, 1997-2005]

Ciência & saúde coletiva, 2011

An evaluative, descriptive, time series study was conducted to evaluate the completeness of varia... more An evaluative, descriptive, time series study was conducted to evaluate the completeness of variables from death certificate. The study population consisted of all deaths of children less than one year old living in Pernambuco State, Brazil, from 1997 to 2005, contained in the database of the Mortality Information System (SIM), provided by the Data Processing Department of the Unified Health System (DATASUS). We calculated each variable's incompleteness (blank/unknown data) by municipality of residence. Based on these data, we calculated the percentage of municipalities with excellent completeness (>95%) and the tendency qui-square (p>95%). There was a difference in the filling behavior of the variables of the death certificate. While sex, age, race/color, place of occurrence, type of delivery and weeks of gestation had an increase in the percentage of municipalities with excellent filling, death confirmed by autopsy, completion of surgery, complement and medical examinati...

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[Evaluation of the completeness of variables on Birth Certificates of residents in Pernambuco State, Brazil, 1996 to 2005]

Cadernos de saúde pública, 2009

An evaluative, descriptive, time series study was conducted to evaluate the completeness of data ... more An evaluative, descriptive, time series study was conducted to evaluate the completeness of data on certificates of live birth. The study population consisted of all live births of residents in Pernambuco State, Brazil, from 1996 to 2005, contained in the database of the Live Birth Information System (SINASC), provided by the Information Technology Department of the Unified National Health System (DATASUS). We calculated each variable's incompleteness (blank/unknown data) by municipality of residence. Based on these data, we calculated the percentage of municipalities with excellent completeness (> 95%), constructed a simple linear regression model, and calculated the determination coefficient. An important increase was observed in the percentage of municipalities with excellent completeness, highlighting the following variables: race/color, maternal schooling, maternal marital status, and number of prenatal visits. The study emphasizes the importance and relevance of using t...

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[Evaluation of the historical series of live births at a tertiary health service--1991 to 2000]

by Lygia Vanderlei and Paulo de Frias

Revista da Associação Médica Brasileira (1992)

This study aimed to analyze some variables found in the Birth Certificates at the Instituto Mater... more This study aimed to analyze some variables found in the Birth Certificates at the Instituto Materno Infantil de Pernambuco, Recife, from July 1991 to December 2000, according to Sinasc (National Information's data base of Births). The statistical analysis was performed using the chi-square test for trend (p<0.05) on EpiInfo software (version 6.0), considering the years 1993 to 2000. The sample comprised a predominance of non-surgical deliveries, adequate gestational age of newborns, weight > 2500 g, Apgar score 1st min and 5th min between 8-10 and mature mothers who had attended from 4 to 6 appointments at prenatal care system. It showed the following rates: cesarean-section of 29.4% to 35.2% (chi2 = 73.7; p<0.01), low weight at birth of 15.9% to 22.8% (chi2 = 170.6; p < 0.01); premature newborns of 9.7% to 23.8% (chi2 = 503.6; p<0.01); teenage mothers of 24.1% to 28.8% (chi2 = 13.3; p<0.01), moreover a high percentage of newborns with Apgar index lower than 3 ...

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Avaliação da completitude das variáveis da declaração de óbitos de menores de um ano residentes em Pernambuco, 1997-2005

Ciência & Saúde Coletiva, 2011

Resumo Com o objetivo de avaliar a completitu-de das variáveis da declaração de óbito de meno-res... more

Coverage Evaluation of the Live Bird Information System, and Contribution of Others Sources for Birth Notification in Two Municipalities of Pernambunco State, Brazil

Summary This article aimed to evaluate the coverage of the Live Birth Information System (Sinasc)... more Summary This article aimed to evaluate the coverage of the Live Birth Information System (Sinasc), and the contribution of others sources for the births records in Bom Conselho and Brejo da Madre de Deus, two Municipalities of Pernambuco State, Brazil, in 1999. This is a case study using data of mothers and children residents in both Municipalities. The data were collected from the Sinasc, records of health centers, and others close to them, and with local health workers and traditional midwives. The coverage, calculated using data by Sinasc and all records of live birth occurred in the two municipalities (Sinasc + search), was high in both (89,1% in Bom Conselho; 97,1% in Brejo). The sources - records of health workers and hospitals - were most important for identification of the children unregistered in the information system.

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Avoidable infant deaths at a reference hospital in Northeast Brazil

by Lygia Vanderlei and Paulo de Frias

Revista Brasileira de …, 2003

Objectives: to classify deaths of children under one year old from January to December 2000, at a... more Objectives: to classify deaths of children under one year old from January to December 2000, at a public Hospital of Pernambuco, according to avoidable basic causes of death. Methods: descriptive cross sectional study using data from the Information System on Mortality processed at the Hospital. The basic causes stated in Death Certificates collected from the medical records and codified under the rules of the Tenth International Disease Classification were grouped according to the criteria proposed by the SEADE Foundation (1991). The coefficient of hospital infant mortality was calculated based on the hospital admission files. Results: the majority of deaths were classified as deaths avoidable by adequate healthcare, with proportional mortality rates of 77,4% for infant deaths, 75,3% for neonatal deaths and 60,1% for post-neonatal deaths, representing an infant death rate of 103,7 deaths per 1.000 hospital admissions. Approximately half were neonates, of these 31% were avoidable through early diagnosis and care. In the post-neonatal group, 44% were principally caused by intestinal infectious diseases and respiratory diseases. Conclusions: the results are suggestive that these high percentages of avoidable deaths were caused by difficulties of access to healthcare services, coverage and/or quality of the assistance.

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Evaluation of child mortality notifications to the Information System for Infant Deaths: a case study

by Lygia Vanderlei, Paulo de Frias, and Pedro Israel Cabral Lira

Revista Brasileira de …, 2005

OBJECTIVES: to assess infant mortality notification to the Mortality Information System (MIS) and... more

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Birth in Brazil survey: neonatal mortality, pregnancy and childbirth quality of care

Cadernos de saúde pública, 2014

This study examined neonatal deaths in the live-births cohort in the Birth in Brazil survey, whic... more This study examined neonatal deaths in the live-births cohort in the Birth in Brazil survey, which interviewed and examined medical records of 23,940 mothers from February 2011 to October 2012. Potential risk factors were analyzed using hierarchical modeling. Neonatal mortality rate was 11.1/1,000, the highest rates occurring in the North and Northeast regions and in lower social classes. Low birth weight, risks during pregnancy and conditions of the newborn were the main factors associated with neonatal death. Inadequate prenatal and childbirth care point to unsatisfactory quality of health care. Difficulty in gaining hospital admission for delivery, and children with birth weight<1,500g born at hospitals without a neonatal intensive care unit, indicate gaps in health system organization. Deaths from intra-partum asphyxia in term babies and late prematurity express preventable neonatal mortality. Better quality health care, especially hospital care during labor and birth, poses ...

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