Notification of juvenile violence in Emergency Services of the Brazilian Unified Health System in Feira de Santana, Bahia, Brazil

OBJECTIVE

To analyze the performance of professionals in the Emergency Units for the notification of cases of violence against children, considering sociodemographic characteristics, professional category and difficulties.

METHODS

Cross-sectional study with a simple random sample (n=200), selected from the universe of professionals (n=523) of these Emergency Units in Feira de Santana, Bahia, Brazil, from a regional general hospital and six polyclinics. Bivariate analyses and measures of association were performed to determine statistical significance.

RESULTS

Most professionals were female (82.5%), aged between 20 and 40 years old (75.5%), being nursing technicians (52.5%) and nurses (22.5%), 69.0% with a temporary employment contract. The notification was recorded by 69.5%, of them, and 60.0% asked for the opinion of another professional; 54.0% talked with the family and 42.9% reported to the Accident and Violence Surveillance System (VIVA). Statistical significance was observed in the nursing technicians category for the notification to sectors of reference, with a 95% confidence interval (95%CI) 1.28 - 2.09; and VIVA (95%CI 1.06 - 7.40). In the medical category, the significant result was not requesting the opinion of another professional (95%CI 1.02 - 3.51); not being afraid of judicial involvement (95%CI 1.19 - 4.06) and being trained in the violence matter (95%CI 1.21 - 5.00). The main difficulties cited were family omission (91.5%), fear of judicial involvement (63.5%) and lack of training (47.0%).

CONCLUSION

Most cases of violence seen at the Emergency Units were notified, however, less than 50% of professionals did not notify VIVA, pointing the need for institutional investment in technical support and ongoing training. Actions addressed to notification strengthen institutions and make the sector responsible for victim care and protection.

Sistema de Vigilância de Violências e Acidentes/VIVA e a notificação da violência infanto-juvenil, no Sistema Único de Saúde/SUS de Feira de Santana-Bahia, Brasil

O estudo tem como objetivo analisar os dados de crianças e adolescentes vítimas das distintas formas de violência, registrados no Sistema de Vigilância de Violências e Acidentes/VIVA/MS, de Feira de Santana, Bahia, Brasil. Utilizou-se o total de registros, desde a implantação do Sistema VIVA no município (01/2009 a 01/2011), cujas análises buscaram associações entre características das violências e perfis de vítimas e agressores. Os resultados mostraram que crianças e adolescentes foram molestados por diversas violências; com uso de força corporal, ameaça verbal e armas; ocorrência de lesões corporais diversas; aproximadamente 35% foram hospitalizados e 15% evoluíram a óbito; a violência física apresentou maior frequência no sexo masculino, nas faixas da adolescência, ocorrência em ambiente domiciliar e causado por familiar; a violência sexual ocorreu com maior proporção no sexo feminino, nas faixas da infância, 55,5% das ocorrências foram em nível domiciliar, sendo mais frequentemente perpetrada por conhecidos e familiares. Os resultados sugerem a importância de investimentos em políticas e programas de prevenção e redução de danos, buscando ampliar a cobertura no atendimento e aprimoramento do Sistema de Informação e levantamento desses indicadores.