Labor and childbirth care in maternity facilities in Brazil's North and Northeast regions: perceptions of the evaluators of the Stork Network Program.

Autor:	Lamy ZC; Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil. zenilamy@gmail.com., Gonçalves LLM; Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil. zenilamy@gmail.com., Carvalho RHSBF; Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil. zenilamy@gmail.com., Alves MTSSBE; Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil. zenilamy@gmail.com., Koser ME; Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil. zenilamy@gmail.com., Martins MS; Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil. zenilamy@gmail.com., Leal NP; Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro RJ Brasil., Thomaz EBAF; Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil. zenilamy@gmail.com.
Jazyk:	Portuguese; English
Zdroj:	Ciencia & saude coletiva [Cien Saude Colet] 2021 Mar; Vol. 26 (3), pp. 951-960. Date of Electronic Publication: 2020 Aug 02.
DOI:	10.1590/1413-81232021263.26572020
Abstrakt:	This article eevaluates delivery and birth care practices in maternity facilities in Brazil's North and Northeast regions. We conducted a qualitative evaluation of 91 facilities in the North and 181 facilities in the Northeast. The data was collected using systematic observation by a team of 44 previously trained evaluators and recorded in a field diary. A thematic analysis of the collected data was performed, resulting in three core themes: challenges of collegial management; challenges for coping with obstetric violence; and the potential of the evaluation process for driving change. Advances were made in the implementation of good labor and childbirth care practices; however, some maternity facilities still reproduce hierarchical models without spaces for collegial management and accounts of obstetric violence were common. Health professionals used the presence of risk to justify the low level of adoption of good practices. However, the findings reveal progress towards the humanization of care. The results also show the potential of the evaluation process for driving change. Although progress has been made towards the adoption of the good practices recommended by the Stork Network Program both in the area of management and care delivery, many challenges remain in view of the dominance of a hierarchical management model associated with an interventionist approach to health care.
Databáze:	MEDLINE
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