Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFMA |
Texto Completo: | https://tedebc.ufma.br/jspui/handle/tede/tede/3888 |
Resumo: | Prenatal care is a set of practices that are fundamental to maternal and neonatal health. However, the socioeconomic, racial, and geographic exclusions that structure Brazilian society have caused inequalities that directly affect access to adequate prenatal care. This study sought to estimate the prevalence and association of the variable color/race with the adequacy of access to prenatal care performed in Brazil. Cross-sectional study based on secondary data and available online in the database of the National Live Births System from the years 2014 to 2019. Sociodemographic, gestational, and prenatal care characteristics by white, brown, and black color/race were estimated (n=16,603,657). Using the information on the number of prenatal visits and trimester of prenatal care initiation, adequacy of access to prenatal care was defined in five categories (from no prenatal care to more than adequate prenatal care). Prevalences for these categories were estimated and crude and adjusted Poisson analysis was performed to verify the association of color/race to the more than adequate category (α=5%). All sociodemographic, gestational, and prenatal characteristics differed statistically between the racial groups (p-value<0.001). In all of them, more than adequate prenatal status prevailed (>50.0%), and over the years this prevalence grew, but with significant differences and time lag (p-value<0.001). In the other prenatal adequacy categories, browns and blacks always had the worst estimates than whites. The positive association between color/race with more than adequate prenatal care was verified in the regression analyses. But, adjustment for this association was observed, with the lowest odds for brown (PR = 1.04; 95%CI: 1.03-1.05) and (PR = 1.07; 95%CI: 1.06-1.08) women. Despite the improvement in the adequacy of access to prenatal care in Brazil, racial inequalities were found in this adequacy, which still indicates the difficulties of the health system in ensuring equity in health in the country. |
id |
UFMA_776c5b7e01ff35d46038c4cd65d25c18 |
---|---|
oai_identifier_str |
oai:tede2:tede/3888 |
network_acronym_str |
UFMA |
network_name_str |
Biblioteca Digital de Teses e Dissertações da UFMA |
repository_id_str |
2131 |
spelling |
OLIVEIRA, Bruno Luciano Carneiro Alves dehttp://lattes.cnpq.br/3811406231128336OLIVEIRA, Bruno Luciano Carneiro Alves dehttp://lattes.cnpq.br/3811406231128336BATISTA, Rosângela Fernandes Lucenahttp://lattes.cnpq.br/3936205532436748PINHEIRO, Ana Karina Bezerrahttp://lattes.cnpq.br/6862658087106562http://lattes.cnpq.br/6469699887537924SILVA, Aída Patrícia da Fonseca Dias2022-07-20T18:09:20Z2022-03-30SILVA, Aída Patrícia da Fonseca Dias. Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014 e 2019. 2022. 59 f. Dissertação (Programa de Pós-Graduação em Enfermagem/CCBS) - Universidade Federal do Maranhão, São Luís, 2022.https://tedebc.ufma.br/jspui/handle/tede/tede/3888Prenatal care is a set of practices that are fundamental to maternal and neonatal health. However, the socioeconomic, racial, and geographic exclusions that structure Brazilian society have caused inequalities that directly affect access to adequate prenatal care. This study sought to estimate the prevalence and association of the variable color/race with the adequacy of access to prenatal care performed in Brazil. Cross-sectional study based on secondary data and available online in the database of the National Live Births System from the years 2014 to 2019. Sociodemographic, gestational, and prenatal care characteristics by white, brown, and black color/race were estimated (n=16,603,657). Using the information on the number of prenatal visits and trimester of prenatal care initiation, adequacy of access to prenatal care was defined in five categories (from no prenatal care to more than adequate prenatal care). Prevalences for these categories were estimated and crude and adjusted Poisson analysis was performed to verify the association of color/race to the more than adequate category (α=5%). All sociodemographic, gestational, and prenatal characteristics differed statistically between the racial groups (p-value<0.001). In all of them, more than adequate prenatal status prevailed (>50.0%), and over the years this prevalence grew, but with significant differences and time lag (p-value<0.001). In the other prenatal adequacy categories, browns and blacks always had the worst estimates than whites. The positive association between color/race with more than adequate prenatal care was verified in the regression analyses. But, adjustment for this association was observed, with the lowest odds for brown (PR = 1.04; 95%CI: 1.03-1.05) and (PR = 1.07; 95%CI: 1.06-1.08) women. Despite the improvement in the adequacy of access to prenatal care in Brazil, racial inequalities were found in this adequacy, which still indicates the difficulties of the health system in ensuring equity in health in the country.A assistência ao pré-natal se constitui em um conjunto de práticas fundamentais à saúde materna e neonatal, entretanto, as exclusões socioeconômicas, raciais e geográficas que estruturam a sociedade brasileira provocaram desigualdades que afetam diretamente no acesso a um pré-natal adequado. Esse estudo buscou estimar a prevalência e a associação da variável cor/raça com a adequação do acesso ao pré-natal realizados no Brasil. Trata-se de um estudo transversal baseado em dados secundários e disponíveis on-line na base de dados do Sistema Nacional de Nascidos Vivos dos anos de 2014 a 2019. Foram estimadas as características sociodemográficas, gestacionais e do pré-natal por cor/raça branca, parda e preta (n = 16.603.657). Utilizando a informação do número de consultas e trimestre de início do pré natal, a adequação do acesso ao pré-natal foi definida em cinco categorias (de não fez a pré natal mais que adequado). Foram estimadas as prevalências para essas categorias e realizou-se análise de Poisson bruta e ajustada para se verificar a associação da cor/raça a categoria mais que adequada (α = 5%). Todas as características sociodemográficas, gestacionais e do pré natal diferiram estatisticamente entre os grupos raciais (p-valor < 0,001). Em todos eles prevaleceu a condição de pré-natal mais que adequado (> 50,0 %) e ao longo dos anos cresceu essa prevalência, mas com diferenças significativas e defasagem temporal (p-valor < 0,001). Nas demais categorias de adequação ao pré-natal, pardas e pretas sempre apresentaram piores estimativas do que as brancas. A associação positiva entre a cor/raça com o pré-natal mais que adequado foi verificada nas análises de regressão, mas observou-se ajuste dessa associação, sendo as menores chances para as pardas (RP = 1,04; IC95%: 1,03-1,05) e (RP = 1,07; IC95%: 1,06 -1,08). Apesar da melhora na adequação do acesso ao pré-natal no Brasil, verificaram-se desigualdades raciais, o que indica a permanência das dificuldades do sistema de saúde em garantir a equidade em saúde no país.Submitted by Daniella Santos (daniella.santos@ufma.br) on 2022-07-20T18:09:20Z No. of bitstreams: 1 AIDAPATRICIA.pdf: 2039740 bytes, checksum: 5110edd0daf9f24f1674938a3274dbed (MD5)Made available in DSpace on 2022-07-20T18:09:20Z (GMT). No. of bitstreams: 1 AIDAPATRICIA.pdf: 2039740 bytes, checksum: 5110edd0daf9f24f1674938a3274dbed (MD5) Previous issue date: 2022-03-30application/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM/CCBSUFMABrasilDEPARTAMENTO DE MEDICINA I/CCBSassistência pré-natal;desigualdade racial em saúde;população negra;pre-natal care;racial inequality in health;black population.Enfermagem de Saúde PúblicaDesigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019Racial inequalities in the adequacy of access to prenatal care in Brazil between 2014 and E 2019info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALAIDAPATRICIA.pdfAIDAPATRICIA.pdfapplication/pdf2039740http://tedebc.ufma.br:8080/bitstream/tede/3888/2/AIDAPATRICIA.pdf5110edd0daf9f24f1674938a3274dbedMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/3888/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/38882022-07-20 15:09:20.943oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312022-07-20T18:09:20Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 |
dc.title.alternative.eng.fl_str_mv |
Racial inequalities in the adequacy of access to prenatal care in Brazil between 2014 and E 2019 |
title |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 |
spellingShingle |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 SILVA, Aída Patrícia da Fonseca Dias assistência pré-natal; desigualdade racial em saúde; população negra; pre-natal care; racial inequality in health; black population. Enfermagem de Saúde Pública |
title_short |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 |
title_full |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 |
title_fullStr |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 |
title_full_unstemmed |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 |
title_sort |
Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014eE 2019 |
author |
SILVA, Aída Patrícia da Fonseca Dias |
author_facet |
SILVA, Aída Patrícia da Fonseca Dias |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
OLIVEIRA, Bruno Luciano Carneiro Alves de |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3811406231128336 |
dc.contributor.referee1.fl_str_mv |
OLIVEIRA, Bruno Luciano Carneiro Alves de |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/3811406231128336 |
dc.contributor.referee2.fl_str_mv |
BATISTA, Rosângela Fernandes Lucena |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/3936205532436748 |
dc.contributor.referee3.fl_str_mv |
PINHEIRO, Ana Karina Bezerra |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/6862658087106562 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6469699887537924 |
dc.contributor.author.fl_str_mv |
SILVA, Aída Patrícia da Fonseca Dias |
contributor_str_mv |
OLIVEIRA, Bruno Luciano Carneiro Alves de OLIVEIRA, Bruno Luciano Carneiro Alves de BATISTA, Rosângela Fernandes Lucena PINHEIRO, Ana Karina Bezerra |
dc.subject.por.fl_str_mv |
assistência pré-natal; desigualdade racial em saúde; população negra; |
topic |
assistência pré-natal; desigualdade racial em saúde; população negra; pre-natal care; racial inequality in health; black population. Enfermagem de Saúde Pública |
dc.subject.eng.fl_str_mv |
pre-natal care; racial inequality in health; black population. |
dc.subject.cnpq.fl_str_mv |
Enfermagem de Saúde Pública |
description |
Prenatal care is a set of practices that are fundamental to maternal and neonatal health. However, the socioeconomic, racial, and geographic exclusions that structure Brazilian society have caused inequalities that directly affect access to adequate prenatal care. This study sought to estimate the prevalence and association of the variable color/race with the adequacy of access to prenatal care performed in Brazil. Cross-sectional study based on secondary data and available online in the database of the National Live Births System from the years 2014 to 2019. Sociodemographic, gestational, and prenatal care characteristics by white, brown, and black color/race were estimated (n=16,603,657). Using the information on the number of prenatal visits and trimester of prenatal care initiation, adequacy of access to prenatal care was defined in five categories (from no prenatal care to more than adequate prenatal care). Prevalences for these categories were estimated and crude and adjusted Poisson analysis was performed to verify the association of color/race to the more than adequate category (α=5%). All sociodemographic, gestational, and prenatal characteristics differed statistically between the racial groups (p-value<0.001). In all of them, more than adequate prenatal status prevailed (>50.0%), and over the years this prevalence grew, but with significant differences and time lag (p-value<0.001). In the other prenatal adequacy categories, browns and blacks always had the worst estimates than whites. The positive association between color/race with more than adequate prenatal care was verified in the regression analyses. But, adjustment for this association was observed, with the lowest odds for brown (PR = 1.04; 95%CI: 1.03-1.05) and (PR = 1.07; 95%CI: 1.06-1.08) women. Despite the improvement in the adequacy of access to prenatal care in Brazil, racial inequalities were found in this adequacy, which still indicates the difficulties of the health system in ensuring equity in health in the country. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-07-20T18:09:20Z |
dc.date.issued.fl_str_mv |
2022-03-30 |
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 |
dc.identifier.citation.fl_str_mv |
SILVA, Aída Patrícia da Fonseca Dias. Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014 e 2019. 2022. 59 f. Dissertação (Programa de Pós-Graduação em Enfermagem/CCBS) - Universidade Federal do Maranhão, São Luís, 2022. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/3888 |
identifier_str_mv |
SILVA, Aída Patrícia da Fonseca Dias. Desigualdades raciais na adequação do acesso ao pré-natal no Brasil entre 2014 e 2019. 2022. 59 f. Dissertação (Programa de Pós-Graduação em Enfermagem/CCBS) - Universidade Federal do Maranhão, São Luís, 2022. |
url |
https://tedebc.ufma.br/jspui/handle/tede/tede/3888 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.publisher.program.fl_str_mv |
PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM/CCBS |
dc.publisher.initials.fl_str_mv |
UFMA |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
DEPARTAMENTO DE MEDICINA I/CCBS |
publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da UFMA instname:Universidade Federal do Maranhão (UFMA) instacron:UFMA |
instname_str |
Universidade Federal do Maranhão (UFMA) |
instacron_str |
UFMA |
institution |
UFMA |
reponame_str |
Biblioteca Digital de Teses e Dissertações da UFMA |
collection |
Biblioteca Digital de Teses e Dissertações da UFMA |
bitstream.url.fl_str_mv |
http://tedebc.ufma.br:8080/bitstream/tede/3888/2/AIDAPATRICIA.pdf http://tedebc.ufma.br:8080/bitstream/tede/3888/1/license.txt |
bitstream.checksum.fl_str_mv |
5110edd0daf9f24f1674938a3274dbed 97eeade1fce43278e63fe063657f8083 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA) |
repository.mail.fl_str_mv |
repositorio@ufma.br||repositorio@ufma.br |
_version_ |
1809926204680044544 |