Atendimento a gestantes no Sistema Único de Saúde

Abstract

KeywordsAntenatal care. Women's health. Unified Health System (SUS-Br). Maternal health services. Pregnant women. Program evaluation. Quality of health care. Abstract ObjectiveTo assess antenatal care in health care units, so as to obtain a baseline for future evaluation studies. Methods A self-applied inquiry was conducted among municipal health managers within a probabilistic stratified random sample of 627 municipalities which, through expansion technique, extended the analysis to 5,507 municipalities. Data was collected from October 2003 to April 2004. The survey appraised information about the priority granted by the managers to each modality of care, as well as data concerning characteristics of the assistance provided and the declared estimate of the demand being covered. The Chi-square test and Student's t-test were performed in order to verify independence among the qualitative variables and mean differences, respectively. Results Almost half (43.8%; n=2,317) of the municipalities did not attend gestational risk; 81% (n=4,277) and 30.1% (n=1,592) reported that they attend over 75% of the demand for low and high risk antenatal respectively; 30.1% (n=1,592) attend over 75% of the demand for high risk care. Care for low risk (χ 2 =282,080; P<0.001 n=4,277) and for high risk pregnancies (χ 2 =267.924; P<0.001 n=5,280) were associated to geographic region, municipality's size and management modality within the Unified Health System. The guarantee of vacancy for labour and birth was also associated to management modality. Conclusions There were gaps related to the provision and the quality of antenatal care within the Unified Health System. Municipal based health care extends the provision of antenatal care, but there are inequalities among regions and among municipalities according to demographic size.services are sufficient to control the identified risks. 10The principal objectives of antenatal care are: to assure the normal development of pregnancy; to prepare the pregnant woman for normal childbirth, for the postpartum period and for normal lactation; to identify risk situations, as quickly as possible. These measures make it possible to prevent the most frequent complications that occur during pregnancy and the postpartum period.

Evaluation of pre-natal care from the perspective of different models in primary care

“…The form in which it is carried out may be indicative of the quality of the health services (1) and, therefore, an assessment of it which considers whether it was undertaken in a center using the traditional model, or in a Family Health Center, can, consequently, evaluate the care model itself.…”

Desempenho de indicadores de processo do Programa de Humanização do Pré-natal e Nascimento no Brasil: uma revisão sistemática

“…Esse seria o estímulo financeiro para incrementar o cumprimento das metas estabelecidas. A disponibilização de recurso financeiro para investimento em individualização de medidas em nível regional é fundamental na organização do cuidado, além da qualidade do serviço de saúde 5,6 . Hoje, mais do que o monitoramento nacional da atenção obstétrica, o SISPRENATAL visa obter informação em saúde durante o pré-natal, parto e puerpério, ação fundamental para avaliação do cuidado em diferentes contextos.…”

Caracterização do acesso à assistência ao parto normal na Bahia, Brasil, a partir da teoria dos grafos

“…Também foi evidenciada uma desigualdade intrarregional, demonstrada pelo grande fluxo de gestantes em direção aos municípios sede de Região de Saúde. Em estudos anteriores, foi observada uma desigualdade regional no uso dos serviços relacionados ao grau de desenvolvimento socioeconômico da região, concentrando-se em zonas urbanas 13,22,23 . Em outra pesquisa, sobre o acesso ao parto no Município do Rio de Janeiro, foi observado que os fluxos das gestantes eram em direção às regiões mais ricas da cidade, ou seja, houve maior busca por assistência ao parto normal nos locais de maior desenvolvimento econômico 24 .…”