Congenital syphilis: performance of primary care services in Sao Paulo, 2017

OBJECTIVE: To evaluate congenital syphilis prevention actions in primary health care services in the state of Sao Paulo. METHODS: Cross-sectional evaluative research that used indicators extracted from the application of the Basic Care Services Assessment and Monitoring (QualiAB) survey in the state of Sao Paulo in 2017. An evaluative matrix was constructed consisting of 31 congenital syphilis prevention indicators, categorized into four domains of analysis: diagnosis and treatment of acquired syphilis (10); infrastructure and basic resources (7); prevention of congenital syphilis in prenatal care (7); and educational actions and prevention of sexually transmitted infections (7). The frequency of services with positive responses for each indicator and the percentage of service performance were calculated based on the proportion of indicators reported per service and the general average observed. Subsequently, the services were classified into four quality groups and associations were estimated between the groups and each indicator, type of organizational arrangement and location. RESULTS: 2,565 services participated, located in 503 municipalities, with an overall average performance of 74.9%. The domain "diagnosis and treatment of acquired syphilis" had the highest performance (89.8%), followed by "infrastructure and basic resources" (79.5%), "prevention of congenital syphilis in prenatal care" (73.3% ) and "educational actions and prevention of sexually transmitted infections" (56.8%). A significant difference was observed between the quality groups and all indicators and types of organizational arrangements. CONCLUSIONS: The services evaluated have limitations in the development of actions to prevent congenital syphilis, mainly related to health education and actions included in prenatal care, such as screening and adequate treatment of pregnant women and their partners. Changes are necessary in the work process, with the expansion of educational and surveillance actions, as well as the qualification of teams to comply with protocols effectively.