Maternal health during the COVID-19 pandemic: Experiences of health workers in three Brazilian municipalities.

Autor: Carvalho RHSBF; Public Health Department, Federal University of Maranhão, São Luís, MA, Brazil., Alves MTSSBE; Public Health Department, Federal University of Maranhão, São Luís, MA, Brazil., Silva-Junior AGD; Fluminense Federal University, Niterói, RJ, Brazil., Alexandre GC; Fluminense Federal University, Niterói, RJ, Brazil., Coimbra TRS; PAHO/WHO, Brasília, DF, Brazil., Moraes M; Federal University of Rio Grande, Pelotas, RS, Brazil., Menezes LO; Catholic University of Pelotas, Pelotas, RS, Brazil., Oliveira SS; Federal University of Rio Grande, Pelotas, RS, Brazil.; Catholic University of Pelotas, Pelotas, RS, Brazil., Thomaz EBAF; Public Health Department, Federal University of Maranhão, São Luís, MA, Brazil., Lamy ZC; Public Health Department, Federal University of Maranhão, São Luís, MA, Brazil., Barreira LSG; PAHO/WHO, Brasília, DF, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Aug 29; Vol. 18 (8), pp. e0290068. Date of Electronic Publication: 2023 Aug 29 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0290068
Abstrakt: Objective: To analyze the experiences of maternal health workers in three Brazilian cities, located in the Northeast (São Luís), Southeast (Niterói), and South (Pelotas) regions during the first year of the COVID-19 pandemic.
Methods: Qualitative research carried out between December 2020 and February 2021. Interviews were conducted, in person or remotely, with 30 health workers, doctors and nurses, working in maternity hospitals of different degrees of complexity.
Results: Sociodemographic characteristics, employment relationships and professional qualification of the interviewees were described. Two thematic axes were identified: 1) changes in hospital organization and dynamics in the pandemic; 2) Illness and suffering of health workers. The majority of respondents were women. Most physicians had work relationships in the public and private sectors. In Niterói, health workers had better professional qualifications and more precarious work relationships (as temporary hires), compared to São Luís and Pelotas. In the context of the uncertainties resulting from the pandemic, this situation generated even more insecurity for those workers. The statements at the beginning of the pandemic covered topics such as changes in the organizational dynamics of services, healthcare, telemedicine, and interaction between health workers and users. In the health workers' perception, the initial period of the health emergency, which resulted in intense changes in the provision of services, was marked by an increase in preterm births, perinatal mortality, and fetal losses. Work overload, fear of contamination, concern for family members and uncertainties regarding the new disease caused intense suffering in health workers who had little institutional support in the cities studied. The suffering experienced by health workers went beyond the work dimension, reaching their private life.
Conclusion: Changes caused by the pandemic required immediate adjustments in professional practices, generating insecurities in healthcare regardless of the location studied. The method of hiring health workers remained the same as the previously practiced one in each city. Due to the risk of disease transmission, measures contrary to humanization practices, and more restrictive in São Luís, were reported as harmful to obstetric care. The Covid-19 pandemic was a huge challenge for the Brazilian health system, aggravating the working conditions experienced by health workers. In addition to the work environment, it was possible to briefly glimpse its effects on private life.
Competing Interests: The authors declare that they have no conflict of interest
(Copyright: © 2023 Carvalho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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