Frequency of public child care service use and associated factors.
OBJECTIVE
Assess the maternal socio-demographic factors associated with the frequency of use of child care services by low income families.


METHODS
Cross-sectional analysis of 393 children between 12 and 16 months old who participated in a randomized field trial during their first year of life in a program of nutritional intervention. The study began in the Brazilian Unified Health System (Sistema Unico de Saúde, SUS) of the maternity hospital in the city of São Leopoldo, state of Rio Grande do Sul, Brazil. Children were examined regarding child care follow-up and vaccination schedule by checking the immunization chart. Data were analyzed using statistical tests Pearson's chi square and prevalence ratio (PR) with respective 95% confidence interval.


RESULTS
The frequency of children who were not continuously taken to the child care service was 53.2%. Multivariate analysis suggests that the factors associated with the lack of continuous use of the service were: mother's educational level <or= 8 years (PR 1.32 95%CI 1.02-1.71), non-nuclear family structure (PR 1.32 95%CI 1.10-1.59) and not being an only child (PR 1.38 95%CI 1.10-1.72). The reasons for lack of follow-up, according to the mothers were: the fact that they thought it unnecessary for 66.2%, problems with the service for 21.7%, difficulties related to their jobs for 6.05%, and other reasons for 6.05%.


CONCLUSIONS
The high frequency of children who were not taken to the child health care service for follow-up is associated with low maternal educational level and family structure, as well as the perception that follow-up visits are not necessary when the child does not have a disease.
Ciências Biológicas, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Márcia Regina
MR
Vitolo
Cíntia Mendes
CM
Gama
Paula Dal Bó
PD
Campagnolo
D002662:Child Health Services / Q000706:statistics & numerical data*; D004522:Educational Status; D004812:Epidemiologic Methods; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000706:statistics & numerical data*; D009035:Mothers / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D012959:Socioeconomic Factors