Sistema Único de Saúde e a redução da mortalidade neonatal no contexto da Rede Cegonha em Alagoas

• Autor(a) principal: Oliveira, Keila Cristina Pereira do Nascimento
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/15919
• topic: Unified Health System; Stork Network; Neonatal Mortality; Maternal and Child Health Services; Alagoas; Sistema Único de Saúde; Rede Cegonha; Mortalidade Neonatal; Serviços de Saúde Materno-Infantil; Alagoas; Mortalidade infantil Alagoas; Sistema Único de Saúde (Brasil); CNPQ::CIENCIAS SOCIAIS APLICADAS::SERVICO SOCIAL

Considering the relevance of the contributions of the Unified Health System (UHS) on the guarantee of living and health conditions, the present study aims at apprehending the possible relations and connections between the Unified Health System and the reduction of neonatal infant mortality in the context of the Stork Network, In Alagoas. It is a literature review, documentary, empirical, analytical, observational, exploratory, with quantitative-qualitative approach. Poverty, as a inherent matter in the very nature of capitalist social relations of exploitation, generates social inequalities that affect the living and health conditions of workers. In spite of the influence of the Brazilian Sanitary Reform Movement in the elaboration of health policy, the neoliberal offensive present in all governments after redemocratization precipitated the reduction of rights; Favored the focus and privatization of health; And limited the preventive and redistributive possibilities of social policies. From the results seized in the documentary analysis, secondary data, interviews with Health Advisers, managers, health professionals and UHS users, a smaller reduction in neonatal mortality was observed in Alagoas in the period from 2011 to 2015, in relation to the country, Evidencing that neonatal infant mortality is determined by the life and health conditions of the pregnant woman, triggered by the responses to the social, economic, cultural and biological needs that, in the context of capitalist society, intensify the class inequalities and the restriction of the right to Health, in a context of the definition of the sector and the focus and fragmentation of the actions and health services offered. Evidenciating the abandonment of primary care, the prioritization of tertiary care financing and the fragile social control, the study also identifies the precariousness of the health services offered to the mother-baby binomial at the tertiary care level, among other factors, such as the lack of primary care, the prioritization of tertiary care financing and the fragile social control. Overcrowding of maternity hospitals, unprepared Alagoas managers for the operationalization of SUS, insufficient number of professionals for health care, absenteeism of doctors, alarming rates of cesarean sections, health judicialization, maternity units (private / contracted) linked to the Stork Network refusing to Attending pregnant women, revealing the dependence of Maternal Child Care on the private and contracted network. Regarding the neonatal deaths occurred in two hospitals in Alagoas, between 2011 and 2015, it´s clear that a close relationship between the sociodemographic factors of the mother (incomplete elementary school, single, age between 20-34 years) with some health indicators of the Network Stork (number of prenatal consultations below 3, prematurity), correlable variables within the scope of the Stork Network Strategy, denoting the fragmentation of the Unified Health System at all levels of attention. In light of the above, in spite of the reduction of mortality in the country and the governmental initiative to reorganize and qualify obstetric and neonatal care, maternal and child health care in Alagoas is still problematic, with repercussions on neonatal mortality and on the quality of care. Assistance to women and children. Thus, the necessary restructuring of health management, as well as the reorganization of health actions, the qualification of the professional-user relationship in the management of the care provided in the puerperal pregnancy period, to improve the living and health conditions of the With a view to reducing neonatal mortality, reaffirming health as the right of the citizen and the duty of the State. Becomes increasingly distant in the context of the structural crisis of capital and the process of demobilization and manipulation of the different segments of the working class. With the state as an arena of struggle between conflicting interests, there is the possibility of resistance and imposition of limits on neoliberal policies, strengthening and expanding the spaces of social control.