Articulation between hospital and primary healthcare: The experience of Brazilian pregnant women

Abstract

Abstract Introduction Primary healthcare was considered by the World Health Organization as one of the ten health priorities for 2019 in the fulfillment of the specific commitments undertaken in the Declaration of Astana in 2018. The integration of the healthcare network in primary healthcare through visits to a maternity of a Brazilian Public teaching Hospital is one of the resourced for the protection and bonding of the pregnant woman. Objective To describe the experience and assessment of pregnant women in relation to visits to the maternity through a participative action between the Teaching Hospital and Primary Healthcare. Methods Qualitative study through a Community Based Participatory Research. Phases: Reduction in the number of visits was identified by the multidisciplinary team associated to actions of the Brazilian Ministry of Health; meetings with primary and hospital healthcare leaders; eight interviews with nurses from the hospital; seven workshops with 34 primary healthcare nurses and interviews with 32 pregnant women after the visit. For the purpose of this study, the interviews with the pregnant women, recorded and transcribed, were stored and organized using the webQDA ® software and thematic analysis performed. Results The pregnant women were of ages between 25 and 32, 63% were primipara and with gestational periods of between 13 and 39. Seven descriptive categories were identified: Care, bonding and health promotion of pregnant women; Challenges of communication with the pregnant women in primary healthcare; Challenges of communication with the pregnant women in hospital care; Clarification of the pregnant women's needs; Strategies for encouraging visits; Reassurance and safety in relation to the hospital; Public healthcare system image. Conclusions Countless challenges are identified by the pregnant women for the rapprochement of primary healthcare and hospital care in the attention to childbirth promoting quality healthcare, bonding and protection. Key messages Integration of healthcare network in primary healthcare through visits to a maternity is one of the resources for the protection and bonding of pregnant woman. Enhance the challenges of pregnant women as the path for rapprochement of primary healthcare and hospital care in the attention to childbirth quality healthcare, bonding and protection.