Acesso ao exame citopatológico: barreiras e possibilidades na atenção primária à saúde de Palmeira dos Índios, Alagoas

Abstract

Introduction: Access to health services refers to people's ability to get the health care and services they need when they need it. Primary Health Care (PHC) has the role of developing strategies for the prevention of cervical cancer, and periodic cytopathological examination is the most adopted strategy for its screening. Objectives: To know the barriers to access to Pap smears in primary care in the municipality of Palmeira dos Índios, Alagoas. Method: This is a descriptive exploratory study with a quantitative approach. The sample consisted of 90 women aged 25 to 64 years, selected through the reports of the Previne Brasil Program of the Ministry of Health, using the criterion of convenience sampling. The data collected were analyzed using the JASP software, version 0.18.3, and the prevalence of non-adherence, prevalence ratios (PR) and their respective confidence intervals (CI) of 95.0% were estimated. Pearson's chi-square test was used to assess the statistical significance of the associations, adopting as significant the values of p<0.05. Results: Good adherence to the Pap smear test was found in the last 3 years (80.46%), however, most women stated that they had had it performed in a private office (64.20%). Issues related to the organization of the health service, such as lack of privacy, delay in delivering the result and the fact that a male professional is responsible for the collection, contribute to this reality. Women who have never had it (6.90%) point out as the main reasons the fact that they are in good health (40%), in addition to shame or lack of time (13.33%). There was a deficiency in knowledge about the exam, because although most considered the exam important (98.89%), many (18.52%) did not know the real reason for its performance and 35.56% reported wanting to receive more information on the subject. In view of this reality, reflecting the various barriers ncountered, a technical product of the professional training type was elaborated, aimed at FHS nurses, seeking to qualify the gynecological nursing consultation with emphasis on the Pap smear. Conclusion: Many women even undergo the test, but choose to do it in the private service, have a weakened bond with the family health team and need more information on the subject. It is necessary to (re)organize the work process, considering the real needs of women in the territory, their way of life, their customs and beliefs. It is expected that the intervention will serve as a pilot for other locations, believing in the positive impact it can generate in the prevention of cervical cancer and in the promotion of women's health, reflecting on the quality of the work of professionals and the services provided to users.