0363/2019 - Desigualdades sociais e geográficas no desempenho da assistência pré-natal de uma Região Metropolitana do Brasil. Social and geographical inequalities in the performance of prenatal care in a metropolitan area of Brazil.
Objetivou-se analisar as desigualdades sociais e geográficas no desempenho da assistência pré-natal no Sistema Único de Saúde, Região Metropolitana da Grande Vitória, Espírito Santo, Brasil. Realizou-se estudo seccional com 1209 puérperas internadas para o parto em 2010 a 2011. Coletaram-se dados sobre assistência médica pré-natal e características contextuais, predisponentes e capacitantes, seguindo o Modelo Comportamental de Andersen. O desempenho da assistência pré-natal foi classificado em cinco níveis incluindo informações sobre: número de consultas pré-natal realizadas; realização de exames iniciais e de repetição; vacinação antitetânica; manejo do risco gestacional e participação em atividades educativas. Analisou-se a chance de diferentes níveis de desempenho do pré-natal por meio de modelo multinomial multivariado, segundo variáveis sociais maternas. Verificou-se alta cobertura pré-natal (98%) e 4,4% de adequação do cuidado. A chance de acesso ao pré-natal foi aumentada por fatores predisponentes, contextual e capacitantes. O aumento na chance de adequação do cuidado foi influenciado por fatores predisponentes e contextuais. A relação entre o pré-natal de qualidade e condições sociais e geográficas da gestante deve orientar a organização dos serviços, visando a equidade e a redução da morbimortalidade materna e perinatal.
Palavras-chave:
Equidade no acesso; Qualidade da assistência à saúde; Sistema Único de Saúde; Cuidado pré-natal.
Abstract:
This study analyzed the social and geographical inequalities in the performance of medical prenatal care in the Unified Health System (SUS) at the Metropolitan Region of Grande Vitória, Espírito Santo, Brazil. A cross-sectional study was carried out including 1,209 puerperal women living in this region, admitted to SUS facilities for childbirth between 2010 and 2011. Data were collected about prenatal care, and contextual, predisposing and social characteristics, following the Andersen´s Behavioral Model. The performance of prenatal care was analyzed according five levels including information on: number of prenatal visits; initial and repetitive examinations; tetanus vaccination; gestational risk management and participation in educational activities. Descriptive statistical analyses were performed, and association test and odds ratios were calculated for adequate prenatal performance and maternal social variables. There was high prenatal coverage (98%) and 4,4% care adequacy. The likelihood of access to prenatal was increased by predisposing, contextual, and social factors. The increase in the chance of adequacy of care was influenced by predisposing and contextual factors. The relationship between prenatal quality and pregnants´s social and geographical conditions must be considered in the organization of services, aiming the equity and the reduction of maternal and infant m
Keywords:
Equity in access; Quality of health care; Unified Health System; Prenatal care.
Social and geographical inequalities in the performance of prenatal care in a metropolitan area of Brazil.
Resumo (abstract):
This study analyzed the social and geographical inequalities in the performance of medical prenatal care in the Unified Health System (SUS) at the Metropolitan Region of Grande Vitória, Espírito Santo, Brazil. A cross-sectional study was carried out including 1,209 puerperal women living in this region, admitted to SUS facilities for childbirth between 2010 and 2011. Data were collected about prenatal care, and contextual, predisposing and social characteristics, following the Andersen´s Behavioral Model. The performance of prenatal care was analyzed according five levels including information on: number of prenatal visits; initial and repetitive examinations; tetanus vaccination; gestational risk management and participation in educational activities. Descriptive statistical analyses were performed, and association test and odds ratios were calculated for adequate prenatal performance and maternal social variables. There was high prenatal coverage (98%) and 4,4% care adequacy. The likelihood of access to prenatal was increased by predisposing, contextual, and social factors. The increase in the chance of adequacy of care was influenced by predisposing and contextual factors. The relationship between prenatal quality and pregnants´s social and geographical conditions must be considered in the organization of services, aiming the equity and the reduction of maternal and infant m
Palavras-chave (keywords):
Equity in access; Quality of health care; Unified Health System; Prenatal care.
Esposti, C.D.D., Santos-Neto, E.T, Emmerich, A.O, Travassos, C, Pinheiro, R.S. Desigualdades sociais e geográficas no desempenho da assistência pré-natal de uma Região Metropolitana do Brasil.. Cien Saude Colet [periódico na internet] (2019/Nov). [Citado em 07/11/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/desigualdades-sociais-e-geograficas-no-desempenho-da-assistencia-prenatal-de-uma-regiao-metropolitana-do-brasil/17437?id=17437&id=17437