O Programa de Humanização no Pré-natal e Nascimento do Ministério da Saúde no Brasil: resultados iniciais

Abstract

This article evaluates the implementation of the Brazilian Ministry of Health's Program for Humanization of Prenatal and Childbirth Care using data generated by the SISPRENATAL/DATASUS database from the Unified National Health System. From its beginning in June 2000 until December 2002, 3,983 municipalities joined the Program, and 71% of participating municipalities (3,183) reported their health care activities, constituting a database with 720,871 women. Nearly 20% of the women had six or more prenatal visits, and approximately half of them had the postpartum follow-up visit and required lab tests performed in 2002. In addition, 41% of the women had been vaccinated against tetanus. The number of HIV antibody tests was twice that of syphilis during the two-year period. Only a small percentage of women (2% in 2001 and 5% in 2002) received the entire set of prenatal and childbirth care services. The low percentages attest to the need for permanent evaluation aimed at improving quality of care and guaranteeing both high-quality maternal and perinatal results and the inalienable right of women to safe care and well-being during pregnancy and delivery.

Violência física entre parceiros íntimos na gestação como fator de risco para a má qualidade do pré-natal

“…Among the national papers published in the last ten years that analyzed the moment of the beginning of prenatal care and the number of attended medical visits in the evaluation of the provided care, the prevalence of pregnant women whose care was classifi ed as inadequate and intermediate varied between 40% and 87%. 2,3,13,20,22,24 Among the strengths of this study, we highlight the classifi cation strategy used for assessing key variables of interest, the cautious fi eldwork and careful analysis model that was used. The Kotelchuck index, used to assess the quality of prenatal care, is employed in different studies and contexts, which allows comparison with other research studies.…”

“…20 This variation is explained by the different quality levels of the services and also by the heterogeneity of the indicators used in the assessment. Although services coverage has improved in the last years, achieving 99% in some municipalities, and the average number of medical visits has increased in many cities, many pregnant women begin to attend prenatal visits after the fi rst trimester of gestation, attend less prenatal visits than recommended and their routine complementary exams are not guaranteed.…”

Evaluation of prenatal care in unit with family health strategy

“…However, few studies have analyzed puerperal return, an occasion to evaluate recovery of women in the postpartum period, institute the use of family planning methods, and monitor breastfeeding. Thus, health care for women during pregnancy should only be considered complete after puerperal consultation (19) . The National Survey on Demography and Health (2006) (20) showed that women attend a postpartum consultation in only 29% of births, emphasizing that this important stage of care has been neglected.…”

“…However, when we extended the analysis to include all basic tests recommended in the PHPB and tetanus immunization, that number dropped dramatically to 9.7%. In Brazil, review of the first years of the PHPB showed that by adding all routine laboratory tests that should be ordered at the beginning of PN, including carrying out of the anti-HIV, less than 5% was considered adequate in 2002 (19) . Thus, the results found in this study suggest an improvement, but far below the proportion of 21% reached in Quixadá in 2004 (28) .…”

A produção de dados para o Sistema de Informação do Pré-Natal em unidades básicas de saúde

“…A monitoring system called SISPRENATAL was enabled, populated systematically with data related to the care of pregnant women (3)(4)(5) . With the publication of Ordinance 1067 (6) , the signature of the term of adherence was dispensed andthe system became available to all districts.…”