Avaliação da assistência pré-natal e puerperal desenvolvidas em região do interior do Estado de São Paulo em 2005

Parada, Cristina Maria Garcia de Lima

doi:10.1590/s1519-38292008000100013

Cited by 31 publications

(47 citation statements)

References 14 publications

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“…Isso também ficou evidente em outros estudos 2,10,11,13,14,19,20 , mostrando que a realização do conjunto, e não das atividades isoladas, é o maior desafio na implementação de uma atenção pré-natal satisfatória 14,20,21 . Ao se levar em consideração apenas o número de consultas e o início do acompanhamento pré-natal preconizado em cada país, foram obtidas adequações que variaram de 27,6 a 82,2% em estudos realizados no Brasil, Estados Unidos e Espanha 10-13,22-25 , sendo que o presente estudo encontrou 69,0% de adequação nesse quesito do pré-natal.…”

Section: Discussionunclassified

“…Porém, a qualidade das consultas ainda não vem revelando bons resultados, pois os índices para a adequação do PHPN são baixíssimos, principalmente quando se incluem os exames de repetição. Foi obtida uma variação de 0 a 15% entre os anos de 2001 a 2012 em diferentes estudos 2,[10][11][12][13][14]26 . Para o presente estudo, a adequação do programa, que há 12 anos norteia o atendimento pré-natal, foi de apenas 7,4%, sendo que os exames de repetição apresentaram proporções em torno de 30%.…”

Section: Discussionunclassified

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Adequação do processo da assistência pré-natal segundo os critérios do Programa de Humanização do Pré-natal e Nascimento e Rede Cegonha

Martinelli¹,

Neto²,

Gama³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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Resumo OBJETIVO: Avaliar a adequação do processo de assistência pré-natal segundo os parâmetros do Programa de Humanização do Pré-natal e Nascimento (PHPN), acrescido dos procedimentos previstos pela Rede Cegonha, no Sistema Único de Saúde (SUS) de uma microrregião do Espírito Santo, Brasil. MÉTODOS: Foi realizado um estudo transversal, em 2012-2013, por meio de entrevistas e de análise do Cartão da Gestante e do prontuário do recém-nascido, com 742 puérperas em 7 maternidades da região escolhida para a pesquisa. As informações foram coletadas, processadas e submetidas aos testes do χ 2 e exato de Fisher para testar a diferença de proporção entre os critérios adotados pelo PHPN mais a Rede Cegonha e o local de moradia, renda familiar mensal e modalidade de cobertura do serviço pré-natal. Foi considerado um nível de significância de 5%. RESULTADOS: Os parâmetros que apresentaram as menores taxas de adequação foram os testes rápidos e os exames de repetição, com frequências em torno de 10 e 30%, respectivamente, além das atividades educativas (57,9%) e da imunização antitetânica (58,7%). Já os parâmetros manejo do risco (92,6%) e exame de glicemia de jejum (91,3%) apresentaram os melhores resultados. Foi encontrada adequação de 7,4% para o PHPN, de 0,4% para a Rede Cegonha, no que diz respeito aos parâmetros da gravidez de risco habitual, e de 0 para os de alto risco. Houve diferença estatisticamente significante entre as puérperas segundo local de moradia para realização de sorologia para sífilis (VDRL), teste anti-HIV e repetição de glicemia de jejum, e a renda familiar mensal influenciou a realização dos exames tipagem sanguínea/fator Rh, VDRL, hematócrito e teste anti-HIV. CONCLUSÃO: A assistência pré-natal no SUS mostrou-se inadequada, de acordo com os procedimentos previstos pelo PHPN e Rede Cegonha na microrregião de um estado do Sudeste brasileiro, principalmente para as mulheres de menor renda, usuárias do PACS e residentes na zona rural. Abstract PURPOSE:To evaluate the adequacy of the process of prenatal care according to the parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the procedures provided by the Stork Network of Unified Health System (SUS) in the microregion of Espirito Santo state, Brazil. METHODS: A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing the records of 742 women during the postpartum period and of their newborns in 7 hospitals in the region chosen for the research. The information was collected, processed and analyzed by the χ 2 and Fisher's exact test to determine the difference in proportion between the criteria adopted by the PHPN and the Stork Network and the place of residence, family income and type of coverage of prenatal service. The level of significance was set at 5%. RESULTS: The parameters showing the lowest adequacy rate were quick tests and repeated exams, with frequencies around 10 and 30%, respectively, in addition to educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk managemen...

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Section: Discussionunclassified

Adequação do processo da assistência pré-natal segundo os critérios do Programa de Humanização do Pré-natal e Nascimento e Rede Cegonha

Martinelli¹,

Neto²,

Gama³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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“…However, other studies have reported the lack of height measurements, provision of educational activities, diet guidance, and evaluation of Body Mass Index (BMI)/gestational age 7,21,[23][24][25] .…”

Section: R E S U L T S a N D Discussionmentioning

confidence: 99%

“…Despite the increase in prenatal care services and programs 4 , the quality of care provided has been affected, and only some of the pregnant women enrolled benefit from the minimum actions carried out in the program 1,[5][6][7] . This suggests inadequacy of the care provided by those services, not only in terms of the number of prenatal visits, but also in terms of the quality of those visits; this situation is even worse for low-income women 6 .…”

Section: Introductionmentioning

confidence: 99%

Nutritional care during prenatal and postpartum periods: A report of experiences in a city on São Paulo's coast

Laporte-Pinfildi

Medeiros

2016

Rev. Nutr.

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The purpose of this study is to present a report of the experiences of the adoption of the Approach to Nutritional Care during Prenatal and Postpartum Periods, resulting from a partnership between the university and the municipal primary health care system of Santos, SP, Brazil. This approach was developed through joint work plans based on the need to incorporate nutritional care into the prenatal and postpartum care. All stages of design and implementation and the results of this strategy were documented in a field diary. This approach was adopted in two basic health units between 2010 and 2014. The stages of this process were planned in conjunction with health care teams and consisted of putting together interdisciplinary groups for nutrition education during the prenatal period. Interdisciplinary educational group meetings were held focusing on listening to the needs of pregnant women, the provision of prenatal nutritional care, and on the project to monitor the nutritional status of newborns through home visits up to the 15 days of postpartum. The interdisciplinary activities strengthened the bond between the users and the health care team members, contributing to the provision of effective care and promoting integrality. Home visiting contributed to encourage exclusive breastfeeding.

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“…Tetanus vaccinations, considered an effective measure in the prevention of neonatal (24) tetanus, has shown low coverage in Brazil (31%) (20) , in Salvador, (33.5%) (25) , and Botucatu, (31.4%) (26) . However, in Curitiba, registration of 87.2% was observed for application of tetanus vaccine (27) .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of prenatal care in unit with family health strategy

Corrêa

Tsunechiro

Lima

et al. 2014

Rev. esc. enferm. USP

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INTRODUCTIONPrenatal care (PN) may contribute to more favorable maternal and perinatal outcomes by enabling early detection and timely treatment of various diseases; in addition to the control of some risk factors that cause complications to women's health and that of newborns (1) .In Brazil, although infant mortality rates have decreased in recent decades, this decline has been uneven across states and municipalities, as well as between areas of a specific municipality (2,3) . To improve national rates and decrease these regional differences, the Brazilian government has taken several measures to increase women's access to prenatal care, in order to qualify the actions developed within it and to modify the model of health care for deliveries.For pregnant women of normal risk, the Program for Humanization of Prenatal and Birth (PHPB) established basic rules for qualified and humanized care, recommending a first prenatal care consultation before the fourth month of pregnancy, at least six prenatal visits (one in the first trimester of pregnancy, two in the second and three in the third), and puerperal consultation until 42 days after birth (4) .Furthermore, in the city of São Paulo, with the goal of improving the quality of maternal-infant care, the Network for the Protection of the Paulistana Mother (Rede de Proteção à Mãe Paulistana) was created in 2006 (5) , which works by way of articulation, integration and monitoring of ambulatory healthcare services as well as municipal and state hospitals. This program aims to ensure: registration and connection of pregnant women to primary healthcare units (PHU) near their homes; inclusion of pregnant women exclusively in the primary healthcare network, regulating the entry point into the healthcare system; linking of pregnant women to reference hospitals in their region and means of transport.Despite the expansion of teams in the Family Health Strategy Service (FHSS) in the municipal healthcare system in São Paulo, the most recent study that evaluated the quality of the prenatal care network occurred in the mid-2000s (6) , and did not specifically focus on primary care. Therefore, there is a knowledge gap, especially in the regions of greatest vulnerability in São Paulo. Recent studies indicate that prenatal care offered by FHSS teams is more in line with the regulations of the PHPB than in the PHU, which has a more traditional organization (7,8) .The objectives of this study were therefore constituted as follows: to analyze the healthcare process of PN in a unit of the FHSS, in accordance with the indicators of the PHPB, and compare the adequacy of the PN with sociodemographic variables, clinical procedures and obstetrics, examinations and maternal and perinatal outcomes. METHODThis study is part of the project Prenatal assessment in a region of the southern area of São Paulo, funded by the National Council for Scientific and Technological Development -CNPq (Case No. 485.264/2011-0), approved by the Research Ethics Committee of the sponsoring institution and the co-par...

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Avaliação da assistência pré-natal e puerperal desenvolvidas em região do interior do Estado de São Paulo em 2005

Cited by 31 publications

References 14 publications

Adequação do processo da assistência pré-natal segundo os critérios do Programa de Humanização do Pré-natal e Nascimento e Rede Cegonha

Adequação do processo da assistência pré-natal segundo os critérios do Programa de Humanização do Pré-natal e Nascimento e Rede Cegonha

Nutritional care during prenatal and postpartum periods: A report of experiences in a city on São Paulo's coast

Evaluation of prenatal care in unit with family health strategy

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