Follow-up with a pediatrician is essential to ensure the full development of children
Less than 10% of the more than 40,000 Brazilian pediatricians provide service under the Brazilian Public Health System
Brazil currently has a population of around 60 million children and adolescents aged from 0 to 18 years. Taking care of children’s health requires a specialized approach, which encompasses the dimensions of promotion, prevention, early diagnosis and assertive treatments. The professional trained to provide this attentive care is the pediatrician. But in Brazil, the vast majority of children and adolescents who depend on the Public Health System (known as SUS) is not monitored by these specialists. This is because, in the public network, there is no mandatory presence of a pediatrician in primary care, made up of basic health units spread across the country.
“Brazil currently has around 40,000 pediatricians. It is the area with the largest number of specialist doctors. However, less than 10% of these professionals are providing service under the SUS,” reveals the technical director of Pequeno Príncipe Hospital, Donizetti Dimer Giamberardino Filho.
The Ministry of Health recommends that, in the first two years of life, a child undergoes nine consultations with the pediatrician to monitor her growth and development, seven consultations in the first year and two in the second year of life. Considering data from 2019, this recommendation would be equivalent to more than 40 million consultations. However, in the same year, just over 1.3 million consultations with pediatricians were carried out in the SUS.
“Every child has the right to be seen by a pediatrician. It is unfair that children from families that can hire a health insurance plan have access to a pediatrician, while children who rely on the SUS do not. This is an unsustainable inequality, as the specialized look of a pediatrician can truly change a child’s life story,” he argues. The drop in vaccination coverage rates and late diagnoses, which often compromise the child’s life, are some of the consequences of the lack of follow-up with a specialized professional.
Training
According to the Brazilian Society of Pediatrics, there are currently more than 270 pediatric residency programs in Brazil. The Pequeno Príncipe Hospital program is one of them and is among the most popular in the country. Created in the 1970s, it has trained more than 2,000 pediatricians from all regions of Brazil, who often, after training, return to their states of origin, qualifying local assistance.
There are around 18.8 pediatricians for each group of 100,000 inhabitants in Brazil, considered an adequate number. However, the distribution of these professionals across the country is uneven. There is a large concentration of pediatricians in the most developed states and capitals. Data from 2022 showed that 55% of pediatricians are in the Southeast Region. The North Region, for example, has only 4% of pediatricians.
In addition to training qualified professionals to work throughout Brazil by means of its residency program, Pequeno Príncipe Hospital holds a continuing education program for doctors and health professionals – the Multiplica PP – which offers online courses in various areas of pediatrics. Launched in 2022, the program has already trained more than a thousand professionals.
Technology has been another tool that Pequeno Príncipe is using to provide assistance to boys and girls in Brazil. Through telemedicine, Pequeno Príncipe pediatricians work in primary care in some municipalities, helping professionals present in basic health units and emergency care units to qualify diagnoses, allowing for more resolute assistance. In the emergency care units in Curitiba, for example, the joint work of the Hospital’s pediatricians and doctors present in the units reduced the need for hospital admission by more than 50%. “The pediatrician’s perspective during the first consultation allows for early diagnoses and treatments, avoiding the worsening of various conditions and, consequently, reducing the need for hospitalization,” explains Giamberardino Filho.
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