Primary care for children with type 1 diabetes mellitus: caregiver perspectives

To evaluate and compare the quality of primary care provided for children with type 1 diabetes mellitus, among the types of public health care services, based on the experience of their main caregivers. Cross-sectional study, grounded in health assessment, using interviews with 55 caregivers of children with type 1 diabetes mellitus, based on the Primary Care Assessment Tool-ChWd Version. Most of the attributes of priman/ health care presented unsatisfactory scores, including the general and essential scores. A greater link with the specialized service (pediatric endocrinology clinics) was found. Although the general and essential scores did not attain satisfactory values, the specialized services achieved better results than the primary health care services, showing, from the perception of the consumers, relevant differences between services. Specialized services were perceived as regular sources of care, and better providers of primary health care practices. This point may be related to the greater contact of the participants with the professionals from the specialized services, and the readiness of these services to care for children with type 1 diabetes mellitus, suggesting fragilities in the primary health care services. The health care of children with type 1 diabetes mellitus, in the studied municipality, shows little presence and extension of primary care attributes, with fragmented and disconnected actions, leading to losses in the integration and expansion of the care network.