Acesso e qualidade da atenção pré-natal na Estratégia Saúde da Família: infraestrutura, cuidado e gestão

Abstract

This study focuses on access to prenatal care and quality of care in the Family Health Strategy in Brazil as a whole and in the North region, through evaluation of infrastructure characteristics in the health units, management, and supply of care provided by the teams, from the perspective of regional and state inequalities. A cross-sectional evaluative and normative study was performed, drawing on the external evaluation component of the second round of the Program for Improvement of Access and Quality of Primary Care, in 2013-2014. The results revealed the inadequacy of the primary healthcare network's infrastructure for prenatal care, low adequacy of clinical actions for quality of care, and the teams' low management capacity to guarantee access and quality of care. In the distribution according to geopolitical regions, the findings pertaining to the units' infrastructure indicate a direct relationship between the infrastructure's adequacy and social contexts with higher municipal human development indices and income. For the clinical actions in patient care, the teams in all the regions scored low on adequacy, with slightly better results in the North and South regions of the country. There were important differences between the states of the North, and the states with higher mean income and human development scored higher on adequacy. The results indicate important organizational difficulties in both access and quality of care provided by the health teams, in addition to visible insufficiency in management activities aimed to improve access and quality of prenatal care.

Strategies For Strengthening High Risk Pregnancy Care In Primary Healthcare Services

“…Although the results suggest that the ESF and mixed units have greater opportunity to perform care for pregnant women of black or brown color, 19 it is pointed out that these groups of pregnant women are unable to perform the recommended routine examinations, they have more commute during childbirth, have a reduced number of prenatal consultations 20 and overall have higher rates of inadequacy for prenatal care 21,22 . This situation reinforces the discussions presented that expanding access to prenatal care was not sufficient for inducing quality care 23 , and although EFS and mixed units are able to strengthen the continuity of care between services, they may not be able to effect care for pregnant women.…”

Status of Prenatal Assistance services for Syphilis Infected Pregnant Women on Region of Baixada Santista, Sp, Brazil

“…The fi ndings possibly refl ect the situation in many regions of the country. Guimarães SG et al [11]. Recently evaluated the access and quality of prenatal care in different regions of Brazil and highlighted the direct correlation between good prenatal care and higher Human Development Indexes (HDI) in each state of Brazil.…”

Avaliação da atenção pré-natal ofertada às mulheres indígenas no Brasil: achados do Primeiro Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas

“…Este estudo avalia a atenção pré-natal de mulheres indígenas com idades entre 21,4% e toxoplasmose 32,6%) e prescrição de sulfato ferroso (44,1%). No conjunto, a proporção de solicitações de exames laboratoriais preconizados não ultrapassou 53%.…”