Preventable infant mortality and quality of health care: maternal perception of the child's illness and treatment

Abstract

This study used a qualitative methodology to analyze the discourse of mothers from Greater Metropolitan Belo Horizonte, Minas Gerais, Brazil, whose infant children had died from what were considered avoidable causes (diarrhea, malnutrition, and pneumonia), seeking to elucidate the factors associated with utilization of health care services. Identification of the illness by the mother was related to perception of specific alterations in the child's state of health. Analysis of the alterations helped identify the principal characteristics ascribed to each alteration and their relationship to the search for treatment. The authors also studied the mother's assessment of treatment received at health care facilities; 43.0% of the cases involved problems related to the structure of health care services or the attending health care professionals. In 46.0% of the cases, mothers associated the child's death with flaws in the health care service. The study group showed a variety of interpretations of illness, often distinct from the corresponding biomedical concepts. The fact that attending health care personnel overlooked or underrated the mother's perception of the illness and the lack of communications between health care personnel and the child's family had an influence on the child's evolution and subsequent death.

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“…En ambos países, usuarios de estratos medios y bajos no sólo consideran que un buen servicio debe contar con recursos humanos suficientes y especializados que resuelvan sus problemas de salud, sino que lo valoran por encima de aspectos superficiales, como serían los elementos estéticos y de comodidad; igualmente calidad en el servicio significa calidad y disposición de medicamentos. En esto último, los usuarios se diferencian de los otros actores, indicando como los formuladores de políticas y muchos del personal de salud, desconocen lo vivido cotidianamente por los usuarios, que buscan ser atendidos por unos servicios poco resolutivos (25,26).…”

Infant death and interpretive violence in Northeast Brazil: taking bereaved Cearense mothers' narratives to heart

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Avoidable deaths in the first four years of life among children in the 2004 Pelotas (Brazil) birth cohort study

“…In addition, many of these deaths are due to avoidable causes 5 , since they are amenable to prevention with available interventions. Taking death as one of the extreme results of quality of care, the proportion of avoidable deaths has been used as an indicator of quality of the health system 6,7,8,9 and its occurrence has been interpreted as a sign of flaws to ARTIGO ARTICLE Santos IS et al …”