Abstract
The aim of this study was to evaluate the quality of prenatal care offered in 12 Basic Health Units (BHU) in the city of Sao Paulo, Brazil, through a review of medical and nurse charts, before and after the municipalization of the public health system. The indicator used considered excellence in care as: starting prenatal care in the first quarter of pregnancy; at least six medical visits; at least two results of blood screening for syphilis and one for HIV; returning to BHU up to 42 days after delivery. This indicator was not present in any care delivered in 2000, and only 7.7% of the care delivered in 2004 obtained it (1.1% to 30% of the care per unit assessed). Although there was an evident improvement in care during the period, the low proportion of excellent prenatal care shows an urgent need to improve this care in the BHU of São Paulo city.
Highlights
Prenatal care is defined as the set of clinical and education procedures to follow-up pregnancy evolvement and to promote the health of pregnant women and their infants
The aim of this study was to evaluate the quality of prenatal care offered in 12 Basic Health Units (BHU) in the city of Sao Paulo, Brazil, through a review of medical and nurse charts, before and after the municipalization of the public health system
The objective of the present study was to assess, using quality indicators, the quality of prenatal care offered in basic health units of the city of São Paulo, comparing distinct periods: 2000 and 2004
Summary
Prenatal care is defined as the set of clinical and education procedures to follow-up pregnancy evolvement and to promote the health of pregnant women and their infants. In Brazil, epidemiological surveillance has managed to appoint problems; it has not been able to enhance the feasibility of prevention measures[1]. The program Humanização no Pré-natal e Nascimento (Prenatal and Birth Humanization Program-PHPN), created by the Ministry of Health in 2000(2), defined minimal procedures for suitable care and established a computerized control system (SisPreNatal) for proper follow-up of pregnant women registered in the PHNP, which is part of the Single Health System (SUS). Municipalization of health services is part of a process of political, technical, and administrative decentralization, translated into the introduction, organization, and management of resources – in São Paulo, this process started in 2001
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