PROJECT: Neuro Pediatric and Reabilitation Clinic Implantation
Purpose: Diognostic and reabilitation treatment
CARACTERIZATION THE LAURO DE FREITAS MUNICIPAL DISTRICT
Lauro de Freitas municipal district is localized up in the north coast of Bahia State.
Diagnostic / Justification
Lauro de Freitas had 163.449 habitants in the last census (2010) occupying the 8th position among the 417 in the state of Bahia in comparison with others municipal districs, and stays on the 162 position among the 5.570. Its demografic density is around 2.833,38 habitants per square kilometer placing on the 2º position of 417 in the state.
Analizing the extimation of growth on the period of 2010 to 2016 the residente population of Lauro de Freitas, the tendency presented a growth of 3,2% on a year,
And deserve prominence the year of 2013 in relation to 2012 ( growth of 7,2% ).
Representing a growth of 13.341 habitants. The tendency of population growth representes an attention at the impacto of the health which must be considered on planning the offer and organizing the services.
Considering the distribution of the population by the ages, projections for 2016 become evidente more percentage on the ages of 30 to 34 years old ( 10,9% ) and 35 to 39 yeas old (10,2% ), the adult population who is on the top of the pyramid
The demografic census of 2010 shows na equilibrium in between men and women residentes of Lauro de Freitas.
Every habitant of Lauro de Freitas in 2014 had an income around of R$31.462,29.
In comparison to others municips of the state its position was 15º of 417 municips and 6º in the metropolitan region.
Analising the number of births alive in Lauro de Freitas, made evidente that there was a growth of the absolute number of alive births between 2012 and 2015, exept on 2016 when there was a redution on the number of births.
When analizing the number of births alive emphasizing the age of the mother from 15 to 19 years old it shows a growth on the perid of 2010 to2012.
On the other end since 2013 until the year of 2015 we can see a enormous growth on adolescent mothers. Pregnancy of the adolescent has bean considered in some countrys, as a public health problem, once that, it can become na obstetric problem with repercussions to the mother and the baby and also psycho social and economic problems. ( YAZZLE, 2016 ).
In Lauro de Freitas the pre birth assistency is associated to a dead rate by possible problems that would be decteted if there was a adequate assistance to the pre birth such as síndrom of hypertension, congenict syphilis and urine infection.
Onother importante datum is the quick expantion of the mosquito Aedes aegypti around the brasilian country emphasizing the quick urbanization with big problems on the water supply and the garbage colleting, and also the enormous prodution of nondegradation materials such as glass and plastic, and olso the cargo and people transportation. On the other end the climate change, which changes the rain regime and high temperatures and also the lack of structure of municipal programs to take care of these determine facts.
In the period of 2010 to 2016 the suspicion and confirmed number of Dengue oscillated, being the years of 2012 to 2016 with more cases ( 678 and 613 each ).
Among all vírus diseases one of particularly worry , is the ZIKA vírus (ZIKV) which the principal way of transmission, is by vectors, and also from mother to the son.The fever by Zicais discribed as intense illness, with 3-7 days duration, normaly without bad complications, althouth it has bean increasing a lot as neurologic manifestations and microcephalic cases at RN's.
In Lauro de Freitas we can see a high number of cases in the year 2015 corresponding to 821 cases with aproximately 429 cases on each a hundred thousand habitants, occuring a big fall to 61 cases in the next year. Althouth the ZICA is not a disease of high lethality it has no epidemic caráter with high neurologic problems which become the problem of hundreds of people that every day go to the health centers, but the municipal has no specialized services for this purpose.
Lauro de Freitas has not yet gave priority to face these questions connected to the citizen with deficiency. This is the segment of the population that always suffer with there rights of coming and go, and the access to public of essencial politics for the quality of life and the opportunitys in relation to all the other citizens.
Its needed to think in strategics to produce significant improvement for the deficiency people through concret actions of the puplic iniciative, to define a sistemic form and inter sectorial to promot the fundamental rights..
The municipal has in its serviçes two units of fisical reabilitation, that attend on the expecialitys of Neurologic, Orthopedic and traumathology..
Children on the first childhood, suffers with the absence of therapeutic spaces to stimulat fisioterapy, psychological and psychopedagogical attendance, among others, which promote a recovery and prevention of motor alternation, neurologic and cardiac respiratory making the use of ludic activitys in orther to make them a part of a Family and a part of the society.
One third of the infant diseases attack nerve system and muscular, and those diseases , such cerebral paralyzation and neurological problems among others can leave to other kind of motor neurological problems attacking above all the development neuro psycho motor. These acometements can make the child to became deficiente
( ROSEMBERG, 1995 ).
The Health World Organization says that aproximatly 10% of the population of any country has any type of deficiency. This deficiency may be parcial, temporary or permanent. These dificiencys or the same limitations can be visual, Auditive, Mental, Fisical or Multiple. In Lauro de Freitas this number narrows the 12%, with the estatistic increase of the diognostic children with the Zika Virus.
In the Rehabilitation Center, the child will always be accompanied by the responsible person. At the first attendiment a minute valuation of the paciente and further on all the conduts and objectives of the threatment, to aim at the funtion reabilitation of the paciente.
Between the most common diseases at the Reabilitation Center of neuro pediatric there are : cerebral paralyzation, Mielomeningocele, muscularesqueléticas, Obstétri paralyzation, Microcefalias, perturbation of the global growth ( the Asperger Sindrome, disturb and desintegration of the chilhood, sindorme of Rett, and the disturb of global growth, without other specification (PDD-NOS) among others
Registred dificultys on the perpective to support the growth and the development of the person, looking further to a better social integration and overcome the clinic dificultys promoting his autonomy as a citizen.
The integral atendence of children, from 0 to 12 years old carrier of development retardation neuropsycomotor, with muscular problems and other bad development problems.
1- Implant a Rehabilitation Center specialized in neuro pediatric.
2- Make integral attendence to 500 children from Zero to 12 years old with neuropsycomotor problems
3- To train 30 (thirty) professionals of the area that will be the atendence.
To sustain the Rehabilitation Center we will have as a partner the Education and Social Assistance Office that can create partnerships to guarantee its full operation.
To assure complete attention to the disabled children in all levels of complexity reassuring to give them therapeutic diagnosis.
Installation of rooms with multifunctional resources to ensure specialized care to all disabled patients, like ones with Global Development Disorder.
Implementation of Rehabilitation workshops.
To guarantee that the Contínuous Cash Benefit (BPC) is offered to the disabled people respecting the criteria of families with per capita income of one minimum wage.
To assure prenatal ultrasonography during the first and last bimesters of pregnancy as many as necessary, offering specialized team for delivery (neonatologist, obstetrician, paediatrician, anesthetist) to promote humanized birth to avoid disabilities resulting of a bad delivery.
To create a Therapeutic Project: the focus of a work concerning disabled people must be their autonomy and effective participation in projects to improve their social and private lives. Each case must be regularly evaluated and adjusted whenever it is necessary.
Rehabilitation and qualification projects require interdisciplinary approach envolving directly professionals, caregivers and family members. All the strategic actions must be established by each child particular needs, considering clinical, emotional, social and environmental impacts of her disability.
The exchange of knowledge and experiences among the team of professionals is extremely important to qualify the care and to prioritize aspects of each phase of the rehabilitation process.
Rehabilitation services must assure:
Diagnosis and functional evaluation of the disability;
Early stimulation to allow children to receive the maximum stimulation to help their better potential development;
Guidelines to caregivers, attendants and family members as important agents in the process of social inclusion and the continuity of the care;
To guide and support families to adjust their environmental and domestic routines in order to offer a better mobility, personal and social autonomy to the patient as well as social, professional and school inclusion;
To offer rehabilitation and qualification services as selection, prescription, provision, maintenance and adjustments of orthosis and prothesis, locomotion facilities according to the patient needs;
To offer individual assistance regarding each patient needs or difficulties;
To promote integration within the healthcare network for disabled people (basic, clinical, urgency and emergency care) to guarantee the care;
To be part of research and study groups that use the therapeutic methods and produce clinical evidences in the field of disability and also search for innovation and use of assertive technology;
To search for other services as social protection, education, sports and culture, to enlarge attention and care and improve the quality of life of disabled people.
GENERAL RULES FOR CRNP AND WORKSHOPS
Physical facilities must follow the rules established by ABNT regarding public building accessibility, space, furniture and urban equipment - ABNT NBR-9050 of May 31st 2014, Resolution - RDC No. 50 ANVISA of February 21 2002, Resolution no. 192 ANVISA of June 28 2002, Ordinance no. 2.728 of November 13 2013 about the Ambiance Manual for Special Rehabilitation Centers (CER) and Orthopedic Workshops Manual of Visual Identity of Healthcare Network for Disabled People and must offer infrastructure facilities as furniture and equipment to guarantee access and quality for the services.
Working Period: minimum of 8 hours daily from Monday to Friday. It may be extended according to the local manager.
Personnel Department: Rehabilitation units and services must have a higher level technical coordinator properly qualified who can be responsible for only one service licensed by th SUS (Public Health System). This coordinator must live wherever he works. His working period is of 40 hours per week. Each rehabilitation service shall form its team with many professionals as needed for working all day long.
The Child Rehabilitation Center might be owned or rented by the Municipal Health Office that will provide guards and maintenance of the equipment and will be responsible for the service organization, provision of human resources and necessary goods for its proper functioning.
The Rotary Foundation shall provide necessary funds to the purchase of equipment and training of the staff to enable them to perform the tasks.
Project Estimated Value
Project Value R$(Estimated)
Construction Municipal Responsability
Training Funds R$ 38.000,00
Equipament R$ 501.615,05
Total R$ 539.615,05
In Dolars US$ 145.841,91