Acquisition and completion of pregnant woman's medical booklet in four populational-based surveys

Abstract

Objectives: to measure the prevalence of acquiring and evaluating the level of completion of the pregnant women's medical booklet on the occasion of childbirth in Rio Grande, Brazil. Methods: this is a cross-sectional study including all puerperals residing in this municipality in 2007, 2010, 2013 and 2016. The mothers were interviewed at the only two local maternities up to 48 hours after childbirth. The data from the pregnant woman’s medical booklet were copied on a standard form. The chi-square test was used to compare proportions. Results: 10,242 pregnant women were included in this study. Of these, 54.8% (CI95%=53.8%-55.7%) had their pregnant woman's medical booklet with them at the time of admission. The completion pattern of the pregnant woman's medical booklet is divided into three groups, namely: with at least 95%: date of the last consultation visit, maternal height and blood pressure verification, uterine height, cardio-fetal heart rate and the Rh factor; 85% or more: date of the last menstruation, qualitative urine test, VDRL and HIV; and less than 30%: performance of clinical breast examination and cytopathology of the uterine cervix. In the private sector, the acquisition of the pregnant woman's medical booklet was 41% lower than at the public sector (62% vs. 44%). Conclusions: the use of the pregnant woman's medical booklet and its completion were lower than expected on several items. Local managers need to work together with the health professionals and these health professionals should work with the mothers to promote the full use of this essential document for the maternal and child's health.

Evolução da assistência à gestação e ao parto no extremo sul do Brasil

“…A posse da Carteira da Gestante costuma ser baixa porque se trata de documento pouco valorizado. Esforços precisam ser feitos para conscientizar as mães sobre a necessidade de levar essa carteira a todas as consultas, assim como os profissionais devem preencher o documento de forma adequada e completa, o que não vem ocorrendo 31 . A utilização correta da Carteira da Gestante otimizaria a oferta de cuidados à gestante e ao recém-nascido.…”

Avaliação da qualidade dos registros de cartões de pré-natal de mulheres urbanas

“…15 Analysis of four surveys in Rio Grande do Sul showed variable filling out over time, presenting almost a general filling out of some items while very scarce of others. 4 A recent Evaluation of antenatal care home-based records Camargos LF, Lemos PL, Martins EF, Felisbino-Mendes MS meta-analysis by the World Health Organization listed several reasons demonstrated as possible causes of under-reporting of these documents by professionals, such as being too busy, or perceiving it as an extra job. It also includes not having received adequate training and thinking that the woman will not read the ANC record, will forget it at home when she goes to the service for the consultation, or even lose the document.…”

“…1,2 For monitoring the pregnancy and its outcome, the home-based ANC record is an indispensable instrument, as it contains the record of the maternal-fetal health condition and the actions taken during consultations. 3,4 The home-based ANC record was created in Brazil in 1988 with the purpose of storing information, facilitating the dialogue between professionals who worked in antenatal care and those who performed childbirth in maternity hospitals. 5 Its use became popular in public health services, functioning as an instrument of dialogue between the levels of care.…”

“…Previous studies have proposed a similar assessment. 2,4,5,13,14 However, the evidence on this topic is still limited, as they partially analyze the data in the ANC record 2,4 and, in most cases, synthesize the evaluation of its completing, 2,4,13 which can mask serious lacks of filling it out, in addition to the expenditure of this type of study. Others have analyzed similar documents, such as the child's record, 15 but so far, the evidence is sparse even to strongly support its use, although it has already been demonstrated, in an international recommendation, that its various benefits outweigh the issues.…”

A systematic review of home-based records in maternal and child health for improving informational continuity, health outcomes, and perceived usefulness in low and middle-income countries

“…Availability or carrying of HBRs to regular health visits, referrals, or consultations. Seven studies measured the availability of HBRs at health care facilities using direct observation (n = 5) [41,45,48,56,57] and women/caregivers' self-reported practice (n = 2) [23,28]. The reported availability of HBRs in health care facilities were 56% (156/300), 76% (516/677), 49.4% (727/1471), 60% (5609/9917), 51% (185/358), 54.6% (100/189) and 83.3% (199/240) respectively.…”