Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) |
Texto Completo: | http://repositorio.uem.br:8080/jspui/handle/1/2317 |
Resumo: | Changes in the Unified Health System (SUS) and the existence of consolidated programs, with the requirement to meet criteria, enable the evaluation practice of services rendered and the health of their users. From the existing programs, the prenatal care is worth mentioning because it is a focus on traditional in the UBS. . It is believed that by identifying strengths and difficulties in their development will be possible to make inferences about other activities in the Basic Health Units (UBS). This study aimed at evaluating the prenatal care in primary care in Maringá; knowing the profile of those mothers who used prenatal service in the UBS; verifying the physical resources used in the care of pregnant women; identifying the professionals working in prenatal care; observing whether the minimum procedures recommended by the Birth and Prenatal Humanization Program (PHPN) are being followed; and verifying the record quality of the assistance given. The literature review, showed that research on maternal health is expanding, but most of the publications used only secondary data. Similar to a study carried out in 1994, the sample consisted of 115 mothers admitted to a charity hospital, accredited to the SUS for deliveries. After the interviews, which used a structured instrument on prenatal care, we visited the twenty-two UBS (88%) where the mothers reported having their prenatal care assistance. The work process, the physical structure, and the use of the Family Health Strategy (ESF) in prenatal care were observed and the quality of medical records was analyzed. Comparison with similar indicators to the previous study and the adapted Kessner index were used to analyze the data, which combined the essential criteria in prenatal care to verify the adequacy of care. The results, showed no significant increase in the number of health facilities in the city and that there are units with inadequate physical infrastructure for the service. However, there was an increase in the number of professionals working in the public health network. The criteria established by the service program is met only partially and the medical records are still undervalued, with no relevant information. When applied the Kessner index for both the perception of mothers as to the records prenatal performed only appropriate when analyzing the number of consultations and the start of monitoring. However, assistance was considered inadequate when the other criteria needed were combined. It was found that the prenatal care and other programs of primary care can be improved. Greater involvement of professionals with prenatal care is needed, especially by members of the ESF and by the male nurse, who must use the tools of this strategy to emphasize their work process and the provision of care to pregnant women. Investment in assessment practices should become regular in the health services in order to enhance the training process and improve decision making in services. |
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Avaliação da assistência pré-natal na rede básica do município de Maringá-ParanáPré-natalAssistênciaAtenção básicaAvaliação de ProgramasEnfermeiroAssistência pré-natalEstratégia Saúde da FamíliaSaúde da famíliaMaringáParaná (Estado)Brasil.Program EvaluationPrimary CarePrenatal careNursesFamily Health StrategyMaringáParaná (State)Brasil.Ciências da SaúdeEnfermagemChanges in the Unified Health System (SUS) and the existence of consolidated programs, with the requirement to meet criteria, enable the evaluation practice of services rendered and the health of their users. From the existing programs, the prenatal care is worth mentioning because it is a focus on traditional in the UBS. . It is believed that by identifying strengths and difficulties in their development will be possible to make inferences about other activities in the Basic Health Units (UBS). This study aimed at evaluating the prenatal care in primary care in Maringá; knowing the profile of those mothers who used prenatal service in the UBS; verifying the physical resources used in the care of pregnant women; identifying the professionals working in prenatal care; observing whether the minimum procedures recommended by the Birth and Prenatal Humanization Program (PHPN) are being followed; and verifying the record quality of the assistance given. The literature review, showed that research on maternal health is expanding, but most of the publications used only secondary data. Similar to a study carried out in 1994, the sample consisted of 115 mothers admitted to a charity hospital, accredited to the SUS for deliveries. After the interviews, which used a structured instrument on prenatal care, we visited the twenty-two UBS (88%) where the mothers reported having their prenatal care assistance. The work process, the physical structure, and the use of the Family Health Strategy (ESF) in prenatal care were observed and the quality of medical records was analyzed. Comparison with similar indicators to the previous study and the adapted Kessner index were used to analyze the data, which combined the essential criteria in prenatal care to verify the adequacy of care. The results, showed no significant increase in the number of health facilities in the city and that there are units with inadequate physical infrastructure for the service. However, there was an increase in the number of professionals working in the public health network. The criteria established by the service program is met only partially and the medical records are still undervalued, with no relevant information. When applied the Kessner index for both the perception of mothers as to the records prenatal performed only appropriate when analyzing the number of consultations and the start of monitoring. However, assistance was considered inadequate when the other criteria needed were combined. It was found that the prenatal care and other programs of primary care can be improved. Greater involvement of professionals with prenatal care is needed, especially by members of the ESF and by the male nurse, who must use the tools of this strategy to emphasize their work process and the provision of care to pregnant women. Investment in assessment practices should become regular in the health services in order to enhance the training process and improve decision making in services.As mudanças ocorridas no Sistema Único de Saúde (SUS) e a existência de programas consolidados, com a exigência de critérios para o atendimento, possibilitam a prática avaliativa dos serviços e da saúde de seus usuários. Dos programas existentes, destaca-se a atenção pré-natal, por se tratar de uma atenção tradicional na rede básica. Acredita-se que, ao identificar facilidades e dificuldades no seu desenvolvimento, será possível fazer inferências sobre as demais atividades nas Unidades Básicas de Saúde (UBS). Este estudo objetivou avaliar a assistência pré-natal na atenção básica em Maringá; conhecer o perfil das puérperas que utilizaram o serviço pré-natal na rede básica; verificar os recursos físicos para o atendimento às gestantes; identificar as categorias de profissionais atuantes na assistência pré-natal; verificar se os procedimentos mínimos preconizados pelo Programa de Humanização no Pré-natal e Nascimento (PHPN) estão sendo realizados e verificar a qualidade dos registros dessa assistência. Na revisão da literatura, percebeu-se que a investigação na área da saúde materna está em expansão, porém em grande parte das publicações se utilizou somente dados secundários. À semelhança de um estudo realizado em 1994, a amostra foi constituída por 115 puérperas, internadas em um hospital filantrópico, credenciado pelo SUS para a assistência ao parto. Após as entrevistas, por meio de um instrumento estruturado sobre a assistência pré-natal, foram visitadas 22 (88%) UBS onde as puérperas informaram ter realizado o pré-natal. Nessas, foram observados o processo de trabalho, a estrutura física, a utilização da Estratégia Saúde da Família (ESF) no pré-natal e analisada a qualidade dos registros em prontuários. Para a análise dos dados utilizou-se a comparação com indicadores semelhantes ao estudo anterior e o índice de Kessner adaptado, que combinou critérios indispensáveis no pré-natal para verificar a adequação da assistência. Na análise dos resultados, percebeu-se que o município não apresentou ampliação significativa na quantidade de unidades de saúde, existem unidades com estrutura física inadequadas para o atendimento, porém houve um incremento de profissionais atuando na rede, os quais cumpriram parcialmente os critérios de atendimento estabelecidos pelo programa e os registros em prontuários permanecem desvalorizados, sem o registro da informação de maneira pertinente. Quando aplicado o índice de Kessner tanto para a percepção das puérperas quanto para os registros o pré-natal se apresentou adequado apenas quando analisado o número de consultas e o início do acompanhamento, porém quando associado a exigência de outros critérios no atendimento, a assistência foi considerada inadequada. Constatou-se que a assistência pré-natal da atenção básica deve ser aprimorada. Para isso, é necessário maior envolvimento dos profissionais com o pré-natal, principalmente os integrantes da ESF e o enfermeiro, que devem utilizar das ferramentas dessa estratégia para qualificar o seu processo de trabalho e a oferta do cuidado às gestantes. O investimento nas práticas avaliativas deve permanecer nos serviços de saúde com o intuito de criar espaço para o processo formativo e melhorar a tomada de decisão nos serviços.75 fUniversidade Estadual de MaringáBrasilPrograma de Pós-Graduação em EnfermagemUEMMaringá, PRDepartamento de EnfermagemMaria José ScochiCélia Regina Rodrigues Gil - UELDeise Serafim - UEMBauli, Janaina Daiane2018-04-10T19:14:31Z2018-04-10T19:14:31Z2009info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttp://repositorio.uem.br:8080/jspui/handle/1/2317porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)instname:Universidade Estadual de Maringá (UEM)instacron:UEM2018-04-10T19:14:31Zoai:localhost:1/2317Repositório InstitucionalPUBhttp://repositorio.uem.br:8080/oai/requestopendoar:2024-04-23T14:55:20.973235Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) - Universidade Estadual de Maringá (UEM)false |
dc.title.none.fl_str_mv |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná |
title |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná |
spellingShingle |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná Bauli, Janaina Daiane Pré-natal Assistência Atenção básica Avaliação de Programas Enfermeiro Assistência pré-natal Estratégia Saúde da Família Saúde da família Maringá Paraná (Estado) Brasil. Program Evaluation Primary Care Prenatal care Nurses Family Health Strategy Maringá Paraná (State) Brasil. Ciências da Saúde Enfermagem |
title_short |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná |
title_full |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná |
title_fullStr |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná |
title_full_unstemmed |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná |
title_sort |
Avaliação da assistência pré-natal na rede básica do município de Maringá-Paraná |
author |
Bauli, Janaina Daiane |
author_facet |
Bauli, Janaina Daiane |
author_role |
author |
dc.contributor.none.fl_str_mv |
Maria José Scochi Célia Regina Rodrigues Gil - UEL Deise Serafim - UEM |
dc.contributor.author.fl_str_mv |
Bauli, Janaina Daiane |
dc.subject.por.fl_str_mv |
Pré-natal Assistência Atenção básica Avaliação de Programas Enfermeiro Assistência pré-natal Estratégia Saúde da Família Saúde da família Maringá Paraná (Estado) Brasil. Program Evaluation Primary Care Prenatal care Nurses Family Health Strategy Maringá Paraná (State) Brasil. Ciências da Saúde Enfermagem |
topic |
Pré-natal Assistência Atenção básica Avaliação de Programas Enfermeiro Assistência pré-natal Estratégia Saúde da Família Saúde da família Maringá Paraná (Estado) Brasil. Program Evaluation Primary Care Prenatal care Nurses Family Health Strategy Maringá Paraná (State) Brasil. Ciências da Saúde Enfermagem |
description |
Changes in the Unified Health System (SUS) and the existence of consolidated programs, with the requirement to meet criteria, enable the evaluation practice of services rendered and the health of their users. From the existing programs, the prenatal care is worth mentioning because it is a focus on traditional in the UBS. . It is believed that by identifying strengths and difficulties in their development will be possible to make inferences about other activities in the Basic Health Units (UBS). This study aimed at evaluating the prenatal care in primary care in Maringá; knowing the profile of those mothers who used prenatal service in the UBS; verifying the physical resources used in the care of pregnant women; identifying the professionals working in prenatal care; observing whether the minimum procedures recommended by the Birth and Prenatal Humanization Program (PHPN) are being followed; and verifying the record quality of the assistance given. The literature review, showed that research on maternal health is expanding, but most of the publications used only secondary data. Similar to a study carried out in 1994, the sample consisted of 115 mothers admitted to a charity hospital, accredited to the SUS for deliveries. After the interviews, which used a structured instrument on prenatal care, we visited the twenty-two UBS (88%) where the mothers reported having their prenatal care assistance. The work process, the physical structure, and the use of the Family Health Strategy (ESF) in prenatal care were observed and the quality of medical records was analyzed. Comparison with similar indicators to the previous study and the adapted Kessner index were used to analyze the data, which combined the essential criteria in prenatal care to verify the adequacy of care. The results, showed no significant increase in the number of health facilities in the city and that there are units with inadequate physical infrastructure for the service. However, there was an increase in the number of professionals working in the public health network. The criteria established by the service program is met only partially and the medical records are still undervalued, with no relevant information. When applied the Kessner index for both the perception of mothers as to the records prenatal performed only appropriate when analyzing the number of consultations and the start of monitoring. However, assistance was considered inadequate when the other criteria needed were combined. It was found that the prenatal care and other programs of primary care can be improved. Greater involvement of professionals with prenatal care is needed, especially by members of the ESF and by the male nurse, who must use the tools of this strategy to emphasize their work process and the provision of care to pregnant women. Investment in assessment practices should become regular in the health services in order to enhance the training process and improve decision making in services. |
publishDate |
2009 |
dc.date.none.fl_str_mv |
2009 2018-04-10T19:14:31Z 2018-04-10T19:14:31Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
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http://repositorio.uem.br:8080/jspui/handle/1/2317 |
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http://repositorio.uem.br:8080/jspui/handle/1/2317 |
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por |
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por |
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info:eu-repo/semantics/openAccess |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Estadual de Maringá Brasil Programa de Pós-Graduação em Enfermagem UEM Maringá, PR Departamento de Enfermagem |
publisher.none.fl_str_mv |
Universidade Estadual de Maringá Brasil Programa de Pós-Graduação em Enfermagem UEM Maringá, PR Departamento de Enfermagem |
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Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) - Universidade Estadual de Maringá (UEM) |
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