Caregivers’ perceptions of the functions of child health surveillance services: exploring (different) patterns of representations

Abstract

Background: The access/use of health services is influenced by patients’ beliefs/knowledge and representations of those services. In the case of immigrants such representations may also be influenced by their experiences with health services of their countries of origin, which may contribute to their health-related vulnerability. This study explored the representations of the functions of child health surveillance services (CHSS) of Cape Verdean and Brazilian immigrants in Portugal and whether such representations were influenced by their socio-economic status (SES). Methods: 5 focus groups (n=19) and 17 semi-structured individual interviews were conducted with immigrants and non-immigrant child caregivers. Data was analyzed with a content analysis methodology, followed by multiple correspondence analysis. Results: CHSS activities were framed in two main functions: health promotion and disease prevention. Some patterns of representations were associated with caregivers’ SES: (1) “vaccination as the main function of CHSS†was a more common representation among immigrants or caregivers of low SES; (2); “CHSS as including several health promotion activities†(e.g., counselling, monitoring of physical growth or psychomotor development) was a representation more often held by non-immigrants or caregivers of high SES. Conclusions: Drawing on a patient-centered perspective, these findings map (non)-immigrant caregivers' representations about CHSS in Portugal, which may contribute to understand their patterns of access and use of CHSS.