Pre-Natal Monitoring in the Primary Attention of the Brazilian Unified Health System

Suzely Adas Saliba Moimaz, Léa Lofego, Nemre Adas Saliba, Tânia Adas Saliba

Abstract


Objective: To analyze prenatal care in the primary care of the Brazilian Unified Health System. Material and Methods: This is a survey cross sectional research with inquiry-type quantitative-qualitative approach. Data collection was performed in 28 cities of the São Paulo state, through on- site observations and interviews with health secretaries, coordinators of primary and oral health care. The following variables were analyzed: Primary health care services for pregnant woman as educational activities, presence of care and referral protocol and the organization of oral health care. Content analysis was performed for the answers of the open questions and the quantitative treatment of the discursive data was obtained through the categorial analysis. For the answers of the closed questions a descriptive analysis was performed. Results: The total number of participants interviewed was 84 managers. It was observed that 78.6 %% of cities carried out educational activities; 42.9% do not have an active care protocol and 57.1% do not have formal referral guidelines to high-risk pregnancies. The rapid tests for HIV, Syphilis, Hepatitis B and C were confirmed by 53.6% of managers and only 39.3% reported evaluating the vaccine situation. As to dental care, 71.4% of the municipalities do not have an established guideline; 46.4% reported that access occurs through spontaneous demand; 32.1% do not consider pregnant woman a priority care group and 67.9% have instituted prenatal dental care. Conclusion: Prenatal care has guaranteed educational activities, but it has deficiencies related to the work process and to the management of services, due, for the most part, to the inexistence of assistance and organizational protocols.


Keywords


Delivery of Health Care; Primary Health Care; Patient Care; Prenatal Care.

Full Text:

PDF

References


Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Atenção ao pré-natal de baixo risco. Brasília: Ministério da Saúde; 2012. [In Portuguese]

Brasil. Ministério da Saúde. Portaria GM/MS nº 569. Institui o Programa de Humanização no Pré-natal e Nascimento, no âmbito do Sistema Único de Saúde. 2000. [In Portuguese]

Serruya SJ, Cecatti JG, Lago TDGD. The Brazilian Ministry of Health's Program for Humanization of Prenatal and Childbirth Care: Preliminary results. Cad Saúde Pública 2004; 20(5):1281-9. https://doi.org/10.1590/S0102-311X2004000500022

Brasil. Ministério da Saúde. Portaria nº 1.459, de 24 de junho de 2011. Institui, no âmbito do Sistema Único de Saúde - SUS - a Rede Cegonha. Diário Oficial da União 2011; jun 25. [In Portuguese]

Tomasi E, Fernandes PAA, Fischer T, Siqueira FCV, Silveira DS, Thumé E, et al. Quality of prenatal services in primary healthcare in Brazil: Indicators and social inequalities. Cad Saúde Pública 2017; 33(3):e00195815. https://doi.org/10.1590/0102-311x00195815

Nunes JT, Gomes KRO, Rodrigues MTP, Mascarenhas MDM. Quality of prenatal care in Brazil: Review of published papers from 2005 to 2015. Cad Saúde Coletiva 2016; 24(2):252-61. https://doi.org/10.1590/1414-462X201600020171

Dantas DS, Mendes RB, Santos JMJ, Valença TS, Mahl C, Barreiro MSC. Quality of prenatal care in the Unified Health System. Rev Enferm UFPE on line 2018; 12(5):1365-71.

https://doi.org/10.5205/1981-8963-v12i5a230531p1365-1371-2018

Mendes RB, Santos JMJ, Prado DS, Gurgel RQ, Bezerra FD, Gurgel RQ. Evaluation of the quality of prenatal care based on the recommendations prenatal and birth humanization program. Cienc Saude Colet 2018; 0362/2018. Avalailable from: http://www.cienciaesaudecoletiva.com.br/artigos/avaliacao-da-qualidade-do-prenatal-a-partir-das-recomendacoes-do-programa-de-humanizacao-no-prenatal-e-nascimento/16895. [Accessed on November 11, 2018].

Tomazettia BM, Hermesb L, Martelloc NV, Schmittd PM, Braze MM, Hoffmannf IC. The quality of pre-natal assistance under a multiprofessional perspective. Ciência & Saúde 2018; 11(1):41-50. https://doi.org/10.15448/1983-652X.2018.1.27078

Bardin L. Análise de Conteúdo. Trad.: Luís Augusto Pinheiro. São Paulo: Edições 70, 2016. [In Portuguese]

Quivy R, Campenhoudt LV. Manual de Investigação em Ciências Sociais. Lisboa: Gradiva, 2005. [In Portuguese]

São Paulo. Secretaria da Saúde. Linha de Cuidado Gestante e Puérpera: Manual Técnico do Pré-Natal, Parto e Puerpério. São Paulo: SES/SP, 2018. [In Portuguese]

Rodrigues EM, Nascimento RG, Araújo A. Prenatal care protocol: Actions and the easy and difficult aspects dealt by Family Health Strategy nurses. Rev Esc Enferm USP 2011; 45(5):1041-7. https://doi.org/10.1590/S0080-62342011000500002

Franco TB, Bueno WS, Merhy EE. "User embracement" and the working process in health: Betim's case, Minas Gerais, Brazil. Cad Saúde Pública 1999; 15(2):345-53.

https://doi.org/10.1590/S0102-311X1999000200019

Melo LMLL, Moimaz SAS, Garbin CAS, Garbin AJI, Saliba NA. The construction of a shared management schedule to reorganise the oral health demand. Rev Ciênc Plural 2016; 2(1):42-55.

OPAS/OMS-Brasil. Folha Informativa: Mortalidade Materna. Brasília, 2018. [In Portuguese]

Brasil. Ministério da Saúde. Ministério da Saúde investe na redução da mortalidade materna. Available from: http://portalms.saude.gov.br/noticias/agencia-saude/43325-ministerio-da-saude-investe-na-reducao-da-mortalidade-materna. [Accessed on November 13, 2018]. [In Portuguese]

Brasil. Ministério da Saúde. Portaria nº 2.436, de 21 de setembro de 2017. Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes para a organização da Atenção Básica, no âmbito do Sistema Único de Saúde (SUS). Available from: http://www.foa.unesp.br/home/pos/ppgops/ portaria-n-2436.pdf. [Accessed on December 14, 2017]. [In Portuguese]

Bordin D, Fadel CB, Moimaz SAS, Garbin CAS, Santos CB, Saliba NA. User satisfaction with the public oral health services in the different dimensions of health care. Pesqui Bras Odontopediatria Clin Integr 2017; 17(1):e3112. https://doi.org/10.4034/PBOCI.2017.171.57

Moimaz SAS, Costa ACO, Saliba NA, Bordim D, Rovida TAD, Garbin CAS. Working conditions and quality of life of Dental Surgeons at the Brazilian Public Health Service. Rev Ciênc Plural 2015; 1(2):68-78.

Campo CEA. Integrality (comprehensiveness): From the viewpoint of health care and the recent proposals regarding basic assistance in Brazil. Cienc Saude Colet. 2003;8(2):569-584. https://doi.org/10.1590/S1413-81232003000200018

Brasil. Ministério da Saúde. Protocolos da Atenção Básica: Saúde das Mulheres. Brasília: Ministério da Saúde; 2016. [In Portuguese]

Vos AA, Leeman A, Waelput AJ, Bonsel GJ, Steegers EA, Denktaş S. Assessment and care for non-medical risk factors in current antenatal health care. Midwifery 2015; 31(10):979-85. https://doi.org/10.1016/j.midw.2015.06.008

Brasil. Ministério da Saúde. Gestantes de todo país devem atualizar caderneta de vacinação. Available from: http://portalms.saude.gov.br/noticias/agencia-saude/42730-gestantes-de-todo-pais-devem-atualizar-caderneta-de-vacinacao. [Accessed on November 20, 2018]. [In Portuguese]

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Estratégicas. Teste Rápido de Gravidez na Atenção Básica: Guia Técnico. Brasília: Ministério da Saúde; 2014. [In Portuguese]

Brasil. Ministério da Saúde. Portaria nº 77, de 12 de janeiro de 2012. Dispõe sobre a realização de testes rápidos, na atenção básica, para a detecção de HIV e sífilis, assim como testes rápidos para outros agravos, no âmbito da atenção pré-natal para gestantes e suas parcerias sexuais. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/prt0077_12_01_2012.html. [Accessed on December 14, 2017]. [In Portuguese]

Cruz SS, Costa MCN, Gomes Filho IS, Vianna MIP, Santos CT. Maternal periodontal disease as a factor associated with low birth weight. Rev Saúde Pública 2005; 39(5):787-7. https://doi.org/10.1590/S0034-89102005000500013

Madruga RCR, Soares RSC, Cardoso AMR, Cavalcanti SALB, Góes PSA, Cavalcanti AL. Access to oral health services in areas covered by the Family Health Strategy, Paraíba, Brazil. Pesqui Bras Odontopediatria Clin Integr 2017; 17(1):e3006. https://doi.org/10.4034/PBOCI.2017.171.06

Carnut L, Filgueiras LV, Figueiredo N, Goes PSA. Initial validation of the index of oral healtcare needs for oral health teams in the family healthcare strategy. Cienc Saude Colet 2011; 16(7):3083-91. https://doi.org/10.1590/S1413-81232011000800008

Brasil. Ministério da Saúde. CONASS. Diretrizes para o Plano de Enfrentamento de Mortalidade Materna e na Infância. Brasília: Ministério da Saúde, 2018. [In Portuguese]




DOI: http://dx.doi.org/10.4034/PBOCI.2019.191.11

PBOCI IS A MEMBER OF CROSSREF AND ALL THE CONTENT OF ITS JOURNALS ARE LINKED BY DOIS THROUGH CROSSREF.