The largest obstetric and neonatal care program and one of the largest public maternity hospital in brazil

Abstract

Objective To analyse the results of a municipal program for obstetric and neonatal care. Study design Observational descriptive epidemiological study. São Paulo is among the five biggest urban agglomerations in the world, with 11 037 593 inhabitants. In 2006, the city authorities launched the Protection Network for São Paulo Mothers, a public program with wide-ranging coverage of prenatal care for pregnant women, going from the first consultation to clinical events and delivery, and coverage of childcare follow-up during the first year of life. The public infrastructure providing this care is formed by 409 primary healthcare units for prenatal follow-up and childcare, 25 specialised outpatient clinics and 36 hospitals. Among the latter is Amparo Maternal, a private philanthropic maternity hospital providing care exclusively within SUS and responsible for around 700 deliveries/month. Results The program currently provides care for 80 000 pregnant women and oversees 10 000 deliveries/month on average, coordinated by a regulatory center (RC) that manages and controls information and ensures admission for pregnant women, parturients and neonates with complications to its referral units. Among requests made to the RC, 81.2% relate to low-risk deliveries, 18.3% to high-risk deliveries, 0.4% to pregnant women with clinical diseases and 0.1% to abortion. There are 36 requests/month on average for referrals of newborns with serious conditions or congenital diseases, particularly within pediatric surgery, neurosurgery and cardiac surgery. Conclusion One of the positive impacts of this program has been its contribution towards reducing the infant mortality in this municipality by more than 10%.