Abstract
This study aimed to compare the evaluation of adequate access to prenatal care according to different indices. Data to construct the indices were obtained from 1,006 patient interviews, prenatal cards, and medical charts for postpartum women who had been admitted for childbirth at maternity hospitals in Greater Metropolitan Vitória, Espírito Santo State, Brazil, from April to September 2010. The various indices for the evaluation of prenatal care were compared to the Kotelchuck index (1994) as the standard reference. Prevalence rates for adequacy were calculated, as were agreement, sensitivity, specificity, predictive values, accuracy, and likelihood ratios. The Takeda index showed the highest prevalence of adequacy (55.8%). The highest agreement was between the indices proposed by Villar et al. and Rosen et al. (adjusted kappa = 0.84). The study concludes that the Carvalho & Novaes index and the Brazilian Ministry of Health index are relevant for assessing adequate access to prenatal care.
Highlights
The first forms of state intervention in maternal and child health date to 18th-century England, through policies focused on childhood and medicalization of childbirth and family health, with the aim of producing more children with decent living conditions, imposing a set of obligations on parents and children 1. permeated by the implicit objective of strengthening a social body capable of fomenting birth and offering support for industrial expansion, such health policies favored important social development, as proven by the control and eradication of various infectious diseases, fostering both increasing life expectancy and important growth in the world population 2.In this phase of the life cycle, prenatal care is an outstanding measure to prevent or decrease the risk of death for both mothers and infants 3
This study aimed to compare the evaluation of adequate access to prenatal care according to different indices
Data to construct the indices were obtained from 1,006 patient interviews, prenatal cards, and medical charts for postpartum women who had been admitted for childbirth at maternity hospitals in Greater Metropolitan Vitória, Espírito Santo State, Brazil, from April to September 2010
Summary
Permeated by the implicit objective of strengthening a social body capable of fomenting birth and offering support for industrial expansion, such health policies favored important social development, as proven by the control and eradication of various infectious diseases, fostering both increasing life expectancy and important growth in the world population 2. In this phase of the life cycle, prenatal care is an outstanding measure to prevent or decrease the risk of death for both mothers and infants 3. In low-risk pregnancies, evidence suggests that few prenatal visits can be as effective as many visits, as long as the proper interventions are performed at the proper time according to each pregnant woman’s needs 6
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