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Research Article| Volume 67, P95-101, November 2022

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Prevalence of children with special healthcare needs: An epidemiological survey in Brazil

  • Andrea Moreira Arrué, PhD
    Andrea Moreira Arrué
    Correspondence
    Corresponding author at: Nursing Postgraduation Program, Federal University of Paraná, 632 Lothario Meissner Street, Didactic Block II, 3rd floor, Jardim Botânico, Curitiba, PR 80210-170, Brazil.
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    Affiliations
    Sergio Arouca National School of Public Health, Fiocruz and Federal Institute of Paraná, Paraná, Brazil
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  • Yara Hahr Marques Hökerberg, PhD
    Yara Hahr Marques Hökerberg
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    Sergio Arouca National School of Public Health, Fiocruz and Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
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  • Leonardo Bigolin Jantsch, PhD
    Leonardo Bigolin Jantsch
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    Federal University of Santa Maria, Rio Grande do Sul, Brazil
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  • Silvana Granado Nogueira da Gama, PhD
    Silvana Granado Nogueira da Gama
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    Sergio Arouca National School of Public Health, Fiocruz, Rio de Janeiro, Brazil
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  • Raquel de Vasconcellos Carvalhaes de Oliveira, PhD
    Raquel de Vasconcellos Carvalhaes de Oliveira
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    Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
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  • Aline Cristiane Cavicchioli Okido, PhD
    Aline Cristiane Cavicchioli Okido
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    Federal University of São Carlos, São Paulo, Brazil
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  • Ivone Evangelista Cabral, PhD
    Ivone Evangelista Cabral
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    Anna Nery School of Nursing, Federal University of Rio de Janeiro and State University of Rio de Janeiro, Rio de Janeiro, Brazil
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  • Regina Aparecida Garcia de Lima, PhD
    Regina Aparecida Garcia de Lima
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    University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
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  • Eliane Tatsch Neves, PhD
    Eliane Tatsch Neves
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    Federal University of Santa Maria, Rio Grande do Sul, Brazil
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Published:September 02, 2022DOI:https://doi.org/10.1016/j.pedn.2022.08.013
Prevalence of children with special healthcare needs: An epidemiological survey in Brazil
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      Advertisement

      Highlights

      • •
        This is the first epidemiological survey of the prevalence of CSHCN in Brazil.
      • •
        One in every four families had one 0–11-year-old child with special health care needs.
      • •
        The CSHCN prevalence was associated with the child's previous health conditions, family structure, socioeconomic, and political context.
      • •
        The instrument facilitates identification of CSHCN in Brazil and allows international comparisons.

      Abstract

      Purpose

      We aimed to estimate the prevalence and delineate the profile of children with special healthcare needs (CSHCN) in the three municipalities of Brazil's southern and southeastern regions from 2015 to 2017.

      Design and methods

      This cross-sectional study included 6853 children aged 0–11 years. Participants were selected through complex sampling in 32 primary healthcare units. The Brazilian version of the Children with Special Healthcare Needs Screener© and a questionnaire were used to identify sociodemographic and family characteristics, health status, and health services utilization. Simple and multiple logistic regression models were used to evaluate the association between family and child characteristics and prevalence (P < 0.05).

      Results

      The prevalence of CSHCN was 25.3% (95% confidence interval: 21.0–30.0). Most participants required health services or were on long-term medication for a current chronic condition; approximately 53% of CSHCN had no formally recorded diagnoses. The most frequent health problems were respiratory conditions, asthma, and allergies. Approximately 60% of the CSHCN patients underwent follow-up examinations of the specialties pneumology, pediatrics, otorhinolaryngology, speech therapy, neurology, and psychology. Children of school age, of male sex, with premature birth, with a history of recurrent hospitalization, from non-nuclear families, and from underprivileged social classes were identified as risk factors for classification as CSHCN.

      Practice implication

      These results contribute to the unprecedented mapping of these children in healthcare networks in Brazil.

      Conclusion

      The high prevalence of CSHCN in medium and large municipalities in the southern and southeastern regions was associated with the child's previous health conditions and family structure.

      Keywords

      • Health care
      • Chronic condition
      • Children's health
      • Health surveys
      • Reproducibility of results

      Abbreviations:

      ABEP (Associação Brasileira de Empresas de Pesquisa (Brazilian Association of Research Companies)), AIC (Akaike′s information criterion), PHC (Primary Healthcare), ATC (Anatomical Therapeutic Chemical), CSHCN (Children with special healthcare needs), CS© (Children with special healthcare needs Screener©), CS©- Brazilian version (Children with special healthcare needs Screener©Brazilian version), PPS (Probability Proportional to Size)
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      Article info

      Publication history

      Published online: September 02, 2022
      Accepted: August 18, 2022
      Received in revised form: August 11, 2022
      Received: May 25, 2022

      Identification

      DOI: https://doi.org/10.1016/j.pedn.2022.08.013

      Copyright

      © 2022 Elsevier Inc. All rights reserved.

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