Monitoring of high-risk children in health services: A geospatial mixed-methods study.
Bianca Machado Cruz Shibukawa, Roberta Tognollo Borota Uema, Natan Nascimento de Oliveira and 3 others
PMID 36629730WHAT IT FOUND
In a Brazilian region, only 26.7% of high-risk children completed recommended monitoring, 17.4% never attended, and 55.9% abandoned follow-up.
Families cited distance, transport gaps, long waits, pandemic fear, and believing healthy children need no monitoring.
Key findings
01Among 3,107 high-risk children's charts, 26.7% completed monitoring, 17.4% never attended, and 55.9% abandoned follow-up.
02Adherence decreased over the study period, and non-adherence increased in municipalities surrounding the outpatient services.
03Families linked non-adherence or abandonment to distance, waiting times, pandemic fear, and believing a healthy child does not need monitoring; some municipal teams reported gaps in active search for missed appointments.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only one Health Region in Paraná was studied, so the rates and themes may not apply elsewhere. The study did not test any intervention, so it cannot show which change would improve attendance. Many eligible families could not be reached or refused, so interviewed family views may not represent all non-adherent or abandoning families. The high-risk denominator was an estimate based on 15% of live births, not a direct count of high-risk births. Remote interviews during the pandemic may have shaped the barriers reported, especially fear of contamination and transport concerns.
Declared interests
The only declaration supplied is that the study was financed in part by CAPES, Finance Code 001. No other competing interests are reported in the text.
The easy way to misread this
Do not conclude that families are simply disengaged from their children's health. The study links non-adherence and abandonment to distance, transport gaps, waiting times, pandemic fear, and incomplete active search, and it did not test any remedy.