0240/2020 - Atenção ao parto e nascimento em maternidades do Norte e Nordeste brasileiros: percepção de avaliadores da Rede Cegonha Health care during delivery and birth in maternities in the North and Northeast of Brazil: perceptions of evaluatorsRede Cegonha
Objetivo: Avaliar práticas de atenção ao parto e nascimento em maternidades do Norte e Nordeste brasileiros.Método: Avaliação qualitativa realizada em 91 maternidades no Norte e 181 no Nordeste do Brasil. A técnica de pesquisa foi a observação sistematizada, realizada por 44 avaliadores previamente treinados e registrada em diário de campo. Foi realizada análise de conteúdo na modalidade temática. Resultados: Os núcleos temáticos foram: Desafios da Gestão Colegiada; Violência Obstétrica; e Potencial do processo avaliativo na indução de mudanças. Foram identificados avanços na implantação de boas práticas na gestão do cuidado e atenção à saúde, embora algumas maternidades ainda reproduzam um modelo hierárquico, sem espaços colegiados de gestão e com práticas de violência obstétrica. Situações de risco em gestantes justificaram menor adesão dos profissionais de saúde às boas práticas, ainda que ações em direção à humanização também tenham sido visibilizadas. Identificou-se a potência do processo avaliativo na indução de mudanças.Conclusão: Foram evidenciadas mudanças em direção às boas práticas preconizadas pela Rede Cegonha, tanto na gestão quanto na atenção, mas são muitos os desafios frente ao predomínio de um modelo de gestão hierárquico associado a um modelo de atenção com práticas intervencionistas.
Palavras-chave:
Avaliação em Saúde; Parto Humanizado; Violência.
Abstract:
Objective: To evaluate childbirth and birth care practices in maternities in the North and Northeast of Brazil. Method: Qualitative assessment carried out in 91 maternity hospitals in the North and 181 in the Northeast Brazil. The research technique was systematic observation, performed by 44 previously trained evaluators and recorded in a field diary. Thematic content analysis was performed. Results: The thematic groups were challenges of collegiate management; obstetric violence and potential of the evaluation process in inducing changes. Advances in the implementation of best practices in management and health care were identified, although some maternity units still reproduce a hierarchical model without collegiate management spaces and with some obstetric violence practices. The presence of risk situations in pregnant women was given as a justification for the lower adherence of health professionals to good practices, however, actions towards humanization have also been detected. During the research it was found that the evaluation process itself was capable of producing changes towards good practices. Conclusion: Changes towards the good practices recommended by Rede Cegonha were evidenced, both in management as in care, but there are many challenges in view of the predominance of a hierarchical management model associated with interventionist practices.
Health care during delivery and birth in maternities in the North and Northeast of Brazil: perceptions of evaluatorsRede Cegonha
Resumo (abstract):
Objective: To evaluate childbirth and birth care practices in maternities in the North and Northeast of Brazil. Method: Qualitative assessment carried out in 91 maternity hospitals in the North and 181 in the Northeast Brazil. The research technique was systematic observation, performed by 44 previously trained evaluators and recorded in a field diary. Thematic content analysis was performed. Results: The thematic groups were challenges of collegiate management; obstetric violence and potential of the evaluation process in inducing changes. Advances in the implementation of best practices in management and health care were identified, although some maternity units still reproduce a hierarchical model without collegiate management spaces and with some obstetric violence practices. The presence of risk situations in pregnant women was given as a justification for the lower adherence of health professionals to good practices, however, actions towards humanization have also been detected. During the research it was found that the evaluation process itself was capable of producing changes towards good practices. Conclusion: Changes towards the good practices recommended by Rede Cegonha were evidenced, both in management as in care, but there are many challenges in view of the predominance of a hierarchical management model associated with interventionist practices.
Lamy, Z.C, Gonçalves, L.L.M., Britto, R.H, Alves, M.T.S.S.B, Koser, M.E, Martins, M.S, Leal, N.P, Thomaz, E.B.A.F.. Atenção ao parto e nascimento em maternidades do Norte e Nordeste brasileiros: percepção de avaliadores da Rede Cegonha. Cien Saude Colet [periódico na internet] (2020/ago). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/atencao-ao-parto-e-nascimento-em-maternidades-do-norte-e-nordeste-brasileiros-percepcao-de-avaliadores-da-rede-cegonha/17722?id=17722
