Nascer no Brasil: continuity of care during pregnancy and postpartum period for women and newborns.

Autor:	Bittencourt SDA; Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil., Cunha EM; Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Laboratório de Educação Profissional em Vigilância em Saúde (LAVSA/EPSJV). Rio de Janeiro, RJ, Brasil., Domingues RMSM; Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/Aids. Rio de Janeiro, RJ, Brasil., Dias BAS; Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Programa de Pós-Graduação em Epidemiologia em Saúde Pública. Rio de Janeiro, RJ, Brasil., Dias MAB; Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil., Torres JA; Agência Nacional de Saúde Suplementar. Rio de Janeiro, RJ, Brasil., Leal MDC; Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil.
Jazyk:	English; Portuguese
Zdroj:	Revista de saude publica [Rev Saude Publica] 2020 Oct 30; Vol. 54, pp. 100. Date of Electronic Publication: 2020 Oct 30 (Print Publication: 2020).
DOI:	10.11606/s1518-8787.2020054002021
Abstrakt:	Objective: To estimate the adequacy of health care during pregnancy and the postpartum period in puerperal women and newborn users of the Unified Health System and verify the factors associated with greater adequacy. Methods: We used data obtained in the hospital interview, the prenatal card and the first telephone interview of 12,646 women participating in the study Nascer no Brasil (Birth in Brazil), conducted in 2011 and 2012. In the first stage of the analysis, the sociodemographic and obstetric characteristics of women and the estimation of adequacy of prenatal and postpartum care indicators are described. In the second stage, the cascade of care for actions related to puerperal women and their newborns is presented. Finally, maternal factors associated with the adequacy of the line of care are verified by means of multiple logistic regression. Results: Only two of the four prenatal indicators were considered satisfactory: initiation up to the 16th week of pregnancy and adequate number of appointments. The guidance on which maternity to go for delivery, as well as the guidance to perform the puerperal appointment and the performance of the heel prick test have reached partial level of adequacy. The puerperal appointment, the first routine appointment of the newborn and the obtaining of the heel prick test results presented unsatisfactory adequacy. In the joint analysis of indicators regarding the effective use of services, only 1.5% of mothers and their babies received all recommended health care. Multiparous women living in the North, Northeast and Midwest, with lower schooling, presented the lowest chances of continuity of care. Conclusions: The indicators evaluated indicate that almost all women and their children presented partial and disjointed care, showing that the coordination of care is still a challenge in the health care of women and children in the puerperal pregnancy period.
Databáze:	MEDLINE
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