The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

Detalhes bibliográficos
Autor(a) principal: Emond, Alan
Data de Publicação: 2002
Outros Autores: Pollock, Jon, Costa, Nilma da, Maranhão, Técia Maria de Oliveira, Macedo, Albanita Leite Soares de
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UFRN
Texto Completo: https://repositorio.ufrn.br/jspui/handle/1/2953
Resumo: EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002
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spelling Emond, AlanPollock, JonCosta, Nilma daMaranhão, Técia Maria de OliveiraMacedo, Albanita Leite Soares de2010-09-03T17:12:39Z2010-09-03T17:12:39Z2002EMOND, A.; POLLOCK, J.; COSTA, N.; MARANHÃO, T. M. O.; MACEDO, A. L. S. (2002)https://repositorio.ufrn.br/jspui/handle/1/2953EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002Objective. To evaluate the effectiveness of a community-based intervention project aimed at reducing maternal and infant mortality in a poor urban district in the city of Natal, in the Northeast of Brazil. Methods. The intervention, called the ProNatal project, introduced a program of integrated community health care to a geographically defined population. The interventions included the establishment of antenatal clinics at the district’s health centers, the opening of the maternity facilities at the polyclinic for low-risk deliveries, the introduction of a family planning clinic and a breast-feeding clinic, support from pediatricians for under-5 (well-baby) clinics, children’s outpatient services and children’s emergency care, and the introduction of health agents recruited from the local community. Representative surveys of the population were taken at the project’s inception (July 1995) and then 30 months later (December 1997), using a general health questionnaire adapted to the local conditions. Mortality data were collected from local registration systems as well as from an autopsy survey of perinatal and infant deaths. Results. During 1995 there were 4 maternal deaths from 1 195 pregnancies (maternal mortality of 335/100 000); three of the deaths were related to hypertension and one to uterine perforation after an illegal abortion. During 1998 (post-intervention), there were no maternal deaths in pregnancy or childbirth. In 1993 no deliveries took place at the polyclinic, but in 1998 there were 946 deliveries at the clinic without any serious complications. The method of delivery, the incidence of prematurity, and the incidence of low birthweight did not change significantly over the study period. In the post-intervention survey, 75% of women reported receiving contraceptive advice from a doctor in the preceding year, compared to 50% in the first sample. A mortality survey carried out in 1993–1995 estimated the infant mortality rate to be 60/1 000 live births. By 1998, using data collected locally by active surveillance, the infant mortality rate was 37/1 000 live births. The causes of infant death in both those periods were dominated by respiratory infections and diarrheal disease. Over 95% of both samples initiated breast-feeding, but a higher proportion of the post-intervention sample reported breast-feeding for longer than 6 months (41% vs. 32%, P = 0.0005). No differences were apparent in the use of under-5 clinics, but immunization rates improved. Post-intervention, significant improvements were documented in the mothers’ understanding of basic hygiene, their knowledge of causes of common diseases, and their management of acute respiratory infections and diarrhea in children. This was particularly true for the households visited by a community health agent. Conclusions. Inequalities in health care in poor urban populations can be reduced by integrated community-based interventions, including the use of health agents recruited from the local communityporDelivery of health carePrimary health careInfant mortalityMaternal mortality, BrazilThe effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRNinstname:Universidade Federal do Rio Grande do Norte (UFRN)instacron:UFRNORIGINALEffectivenessCommunity-based_Emond_2002.pdfEffectivenessCommunity-based_Emond_2002.pdfapplication/pdf209610https://repositorio.ufrn.br/bitstream/1/2953/1/EffectivenessCommunity-based_Emond_2002.pdf894751d304f07067d690f56fe6947f9cMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorio.ufrn.br/bitstream/1/2953/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52TEXT2002Art_TeciaMOM_TheEffectiveness.pdf.txt2002Art_TeciaMOM_TheEffectiveness.pdf.txtExtracted texttext/plain49567https://repositorio.ufrn.br/bitstream/1/2953/7/2002Art_TeciaMOM_TheEffectiveness.pdf.txt7507e90da24dd24ad9fe1b37ec785f69MD57THUMBNAIL2002Art_TeciaMOM_TheEffectiveness.pdf.jpg2002Art_TeciaMOM_TheEffectiveness.pdf.jpgIM Thumbnailimage/jpeg5964https://repositorio.ufrn.br/bitstream/1/2953/8/2002Art_TeciaMOM_TheEffectiveness.pdf.jpg580c533cef9369b4fcf450f3fd62b370MD581/29532021-11-12 15:44:59.169oai:https://repositorio.ufrn.br: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Repositório de PublicaçõesPUBhttp://repositorio.ufrn.br/oai/opendoar:2021-11-12T18:44:59Repositório Institucional da UFRN - Universidade Federal do Rio Grande do Norte (UFRN)false
dc.title.pt_BR.fl_str_mv The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
title The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
spellingShingle The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
Emond, Alan
Delivery of health care
Primary health care
Infant mortality
Maternal mortality, Brazil
title_short The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
title_full The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
title_fullStr The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
title_full_unstemmed The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
title_sort The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil
author Emond, Alan
author_facet Emond, Alan
Pollock, Jon
Costa, Nilma da
Maranhão, Técia Maria de Oliveira
Macedo, Albanita Leite Soares de
author_role author
author2 Pollock, Jon
Costa, Nilma da
Maranhão, Técia Maria de Oliveira
Macedo, Albanita Leite Soares de
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Emond, Alan
Pollock, Jon
Costa, Nilma da
Maranhão, Técia Maria de Oliveira
Macedo, Albanita Leite Soares de
dc.subject.por.fl_str_mv Delivery of health care
Primary health care
Infant mortality
Maternal mortality, Brazil
topic Delivery of health care
Primary health care
Infant mortality
Maternal mortality, Brazil
description EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002
publishDate 2002
dc.date.issued.fl_str_mv 2002
dc.date.accessioned.fl_str_mv 2010-09-03T17:12:39Z
dc.date.available.fl_str_mv 2010-09-03T17:12:39Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.citation.fl_str_mv EMOND, A.; POLLOCK, J.; COSTA, N.; MARANHÃO, T. M. O.; MACEDO, A. L. S. (2002)
dc.identifier.uri.fl_str_mv https://repositorio.ufrn.br/jspui/handle/1/2953
identifier_str_mv EMOND, A.; POLLOCK, J.; COSTA, N.; MARANHÃO, T. M. O.; MACEDO, A. L. S. (2002)
url https://repositorio.ufrn.br/jspui/handle/1/2953
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