Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy

Detalhes bibliográficos
Autor(a) principal: Silva, Esther Pereira da
Data de Publicação: 2019
Outros Autores: Leite, Antônio Flaudiano Bem, Lima, Roberto Teixeira, Osório, Mônica Maria
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/158062
Resumo: OBJECTIVE: To characterize prenatal care and verify possible factors associated with its adequacy. METHODS: This is a cross-sectional study based on interviews with health care professionals and consultations on official documents of women attending prenatal of the primary health care in the city of João Pessoa, capital of Paraíba, in the Northeast region of Brazil. Prenatal care was evaluated by an index with criteria referring to aspects of structure, process and outcome, denominated IPR/Prenatal. The multivariate logistic regression method revealed that demographic, socioeconomic, reproductive and maternal morbidity variables were possible determinants for prenatal adequacy. RESULTS: The survey involved 130 services and 1,625 primary health care patients. Prenatal care was adequate in approximately 23% of the cases. Low prevalence of referral to maternity, educational strategies and examinations were observed. The analysis showed that nonadolescent women (OR = 1,390), with a longer period of schooling (OR = 1.750), higher per capita income (OR = 1,870) and primiparous women (OR = 1,230) were more likely to have an adequate prenatal. CONCLUSIONS: Prenatal care, when evaluated by broader criteria, showed a low percentage of adequacy. Strategies should be developed to ensure the referral to the maternity where the birth will take place and health education activities and examinations to provide adequate prenatal care in the municipality under study. In addition, factors associated with adequacy must be considered by managers and health professionals.
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spelling Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacyAvaliação do pré-natal na atenção primária no Nordeste do Brasil: fatores associados à sua adequaçãoPrenatal Care, organization & administrationHealth Services CoverageOutcome and Process Assessment (Health Care)Health Status DisparitiesCuidado Pré-Natal, organização & administraçãoCobertura de Serviços de SaúdeAvaliação de Processos e Resultados (Cuidados de Saúde)Disparidades nos Níveis de SaúdeOBJECTIVE: To characterize prenatal care and verify possible factors associated with its adequacy. METHODS: This is a cross-sectional study based on interviews with health care professionals and consultations on official documents of women attending prenatal of the primary health care in the city of João Pessoa, capital of Paraíba, in the Northeast region of Brazil. Prenatal care was evaluated by an index with criteria referring to aspects of structure, process and outcome, denominated IPR/Prenatal. The multivariate logistic regression method revealed that demographic, socioeconomic, reproductive and maternal morbidity variables were possible determinants for prenatal adequacy. RESULTS: The survey involved 130 services and 1,625 primary health care patients. Prenatal care was adequate in approximately 23% of the cases. Low prevalence of referral to maternity, educational strategies and examinations were observed. The analysis showed that nonadolescent women (OR = 1,390), with a longer period of schooling (OR = 1.750), higher per capita income (OR = 1,870) and primiparous women (OR = 1,230) were more likely to have an adequate prenatal. CONCLUSIONS: Prenatal care, when evaluated by broader criteria, showed a low percentage of adequacy. Strategies should be developed to ensure the referral to the maternity where the birth will take place and health education activities and examinations to provide adequate prenatal care in the municipality under study. In addition, factors associated with adequacy must be considered by managers and health professionals.OBJETIVO: Caracterizar a assistência pré-natal e verificar possíveis fatores associados à sua adequação. MÉTODOS: Este é um estudo transversal realizado a partir de entrevistas com os profissionais de serviços de saúde e de consultas em documentos oficiais de mulheres assistidas no pré-natal da atenção primária à saúde na cidade de João Pessoa, capital da Paraíba, na região Nordeste brasileira. O pré-natal foi avaliado por meio de um índice com critérios referentes aos aspectos de estrutura, processo e resultado, denominado IPR/Pré-Natal. Verificou-se pelo método de regressão logística multivariada se variáveis demográficas, socioeconômicas, reprodutivas e de morbidades maternas foram possíveis fatores determinantes para a adequação do pré-natal. RESULTADOS: A pesquisa envolveu 130 serviços e 1.625 pacientes da atenção primária de saúde. O pré-natal se apresentou adequado em aproximadamente 23% dos casos. Foram observadas baixas prevalências de encaminhamento à maternidade, estratégias educativas e realização de exames. As análises mostraram que mulheres não adolescentes (OR = 1,390), com maior tempo de escolaridade (OR = 1,750), maior renda per capita (OR = 1,870) e primíparas (OR = 1,230) apresentaram maiores chances de ter um pré-natal adequado. CONCLUSÕES: O pré-natal, ao ser avaliado por critérios mais amplos, mostrou baixo percentual de adequação. Devem ser elaboradas estratégias que garantam o encaminhamento para a maternidade onde será feito o parto e a realização de atividades de educação em saúde e dos exames para propiciar o pré-natal adequado no município estudado. Além disso, os fatores associados à adequação devem ser levados em conta por parte dos gestores e profissionais de saúde.Universidade de São Paulo. Faculdade de Saúde Pública2019-05-16info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfapplication/xmlhttps://www.revistas.usp.br/rsp/article/view/15806210.11606/S1518-8787.2019053001024Revista de Saúde Pública; Vol. 53 (2019); 43Revista de Saúde Pública; Vol. 53 (2019); 43Revista de Saúde Pública; v. 53 (2019); 431518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/158062/153330https://www.revistas.usp.br/rsp/article/view/158062/153331https://www.revistas.usp.br/rsp/article/view/158062/153332Copyright (c) 2019 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessSilva, Esther Pereira daLeite, Antônio Flaudiano BemLima, Roberto TeixeiraOsório, Mônica Maria2019-05-17T13:50:28Zoai:revistas.usp.br:article/158062Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2019-05-17T13:50:28Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
Avaliação do pré-natal na atenção primária no Nordeste do Brasil: fatores associados à sua adequação
title Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
spellingShingle Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
Silva, Esther Pereira da
Prenatal Care, organization & administration
Health Services Coverage
Outcome and Process Assessment (Health Care)
Health Status Disparities
Cuidado Pré-Natal, organização & administração
Cobertura de Serviços de Saúde
Avaliação de Processos e Resultados (Cuidados de Saúde)
Disparidades nos Níveis de Saúde
title_short Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
title_full Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
title_fullStr Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
title_full_unstemmed Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
title_sort Prenatal evaluation in primary care in Northeast Brazil: factors associated with its adequacy
author Silva, Esther Pereira da
author_facet Silva, Esther Pereira da
Leite, Antônio Flaudiano Bem
Lima, Roberto Teixeira
Osório, Mônica Maria
author_role author
author2 Leite, Antônio Flaudiano Bem
Lima, Roberto Teixeira
Osório, Mônica Maria
author2_role author
author
author
dc.contributor.author.fl_str_mv Silva, Esther Pereira da
Leite, Antônio Flaudiano Bem
Lima, Roberto Teixeira
Osório, Mônica Maria
dc.subject.por.fl_str_mv Prenatal Care, organization & administration
Health Services Coverage
Outcome and Process Assessment (Health Care)
Health Status Disparities
Cuidado Pré-Natal, organização & administração
Cobertura de Serviços de Saúde
Avaliação de Processos e Resultados (Cuidados de Saúde)
Disparidades nos Níveis de Saúde
topic Prenatal Care, organization & administration
Health Services Coverage
Outcome and Process Assessment (Health Care)
Health Status Disparities
Cuidado Pré-Natal, organização & administração
Cobertura de Serviços de Saúde
Avaliação de Processos e Resultados (Cuidados de Saúde)
Disparidades nos Níveis de Saúde
description OBJECTIVE: To characterize prenatal care and verify possible factors associated with its adequacy. METHODS: This is a cross-sectional study based on interviews with health care professionals and consultations on official documents of women attending prenatal of the primary health care in the city of João Pessoa, capital of Paraíba, in the Northeast region of Brazil. Prenatal care was evaluated by an index with criteria referring to aspects of structure, process and outcome, denominated IPR/Prenatal. The multivariate logistic regression method revealed that demographic, socioeconomic, reproductive and maternal morbidity variables were possible determinants for prenatal adequacy. RESULTS: The survey involved 130 services and 1,625 primary health care patients. Prenatal care was adequate in approximately 23% of the cases. Low prevalence of referral to maternity, educational strategies and examinations were observed. The analysis showed that nonadolescent women (OR = 1,390), with a longer period of schooling (OR = 1.750), higher per capita income (OR = 1,870) and primiparous women (OR = 1,230) were more likely to have an adequate prenatal. CONCLUSIONS: Prenatal care, when evaluated by broader criteria, showed a low percentage of adequacy. Strategies should be developed to ensure the referral to the maternity where the birth will take place and health education activities and examinations to provide adequate prenatal care in the municipality under study. In addition, factors associated with adequacy must be considered by managers and health professionals.
publishDate 2019
dc.date.none.fl_str_mv 2019-05-16
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/158062
10.11606/S1518-8787.2019053001024
url https://www.revistas.usp.br/rsp/article/view/158062
identifier_str_mv 10.11606/S1518-8787.2019053001024
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/158062/153330
https://www.revistas.usp.br/rsp/article/view/158062/153331
https://www.revistas.usp.br/rsp/article/view/158062/153332
dc.rights.driver.fl_str_mv Copyright (c) 2019 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2019 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
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dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 53 (2019); 43
Revista de Saúde Pública; Vol. 53 (2019); 43
Revista de Saúde Pública; v. 53 (2019); 43
1518-8787
0034-8910
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repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
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