Assistance and assessment of the health situation of high-risk newborn children in a Sanitary District of Belo Horizonte: challenges beyond the child survival

Abstract

Introdution: Newborns who survive with extreme weight and gestational age, with asphyxia and/or congenital malformations, have increased the risk of morbidity and mortality and demand more health attention. Objective: to evaluate the assistance and health situation of high-risk children in the first three years of life and the implementation of the High-risk Newborn Protocol from the Health Municipal Secretary of Belo Horizonte. Methods: this was a noncompetitive cohort study of high-risk children (birth weight ≤ 2000 grams and/or Apgar < 7 in the fifth minute of life), born in 2006, in a sanitary district of Belo Horizonte-MG, identified in the System of Information on Live Births. The data were collected through an assessment of the children and a structured interview with their parents. We evaluated the actions advocated by the Protocol and considered as: not implemented (<40%), partially implemented (40 to 79%), and implemented (≥ 80%). Results: 165 children were identified; 42 died, 41 of them in the first year of life (infant mortality rate of 248 deaths per 1,000 live births); and 58 were excluded for other reasons. Among the 65 evaluated children, approximately 31, 16.9, 35, and 63.2% were followedup by the primary health care as advocated; were in a specialized monitoring; were not screened for hearing and prematurity anemia; and were not screened for bone metabolic disease, respectively. The time for breastfeeding and supplementation of vitamins and iron, as well as the use of special vaccines, was also inadequate. Conclusion: the monitor ing of high-risk children was unsatisfactory because the recommended health actions were partially implemented. The improvement in the attention to these children is necessary to promote their health and quality of life throughout the period set by the program.