Comprehensive health care for women in a public hospital in Sao Paulo, Brazil

This paper describes a model of integrated reproductive health care service s for women at the primary health core level, put into practice at the Pero la Byington Hospital, Sao Paulo, Brazil, from 1991 to 1998. Some 2,000 wome n from poor social strata, whose health condition was poor, were being seen every day in the lost two years of the programme, including new consultati ons and women with a previous attendance returning. Women were attended fir st by nurse-assistants, who hod been trained to screen for the most frequen t gynaecological problems, and then a physician. Because doctors spent less time with each patient, four times as many women could be seen. Programmes were set up for the diagnosis and treatment of gynaecological cancers, STD s, HIV/AIDS, hypertension and other degenerative disorders such as diabetes . Screening and treatment programmes for cervical and breast cancer achieve d significant improvements in the stage at which a diagnosis was mode, allo wing more lives to be saved. This model also succeeded in decreasing the co sts for these health services per woman seen.