Abstract
To describe the methodological and operational aspects of an epidemiological and an evaluation of Rede Cegonha in Santa Catarina, Brazil. The research carried out in 2019 was composed of two sub-studies. Regarding the first, whose design was epidemiological and analyzed prenatal, delivery and immediate puerperium care addressed to pregnant women, puerperal women and children assisted at SUS, the instruments used for data collection and the organization of the field of the study are described. The other sub-study was a normative assessment of municipal management in prenatal and postpartum care within the scope of Rede Cegonha. It began with an evaluability assessment followed by the assessment itself. The different methodological strategies adopted are described, with the involvement of stakeholders and experts. The response rate of the epidemiological sub-study was 97.7%. Women residing in 82.7% of Santa Catarina's municipalities were interviewed. The sample was similar to that registered in SINASC for the same period, and the characteristics of the sub-sample interviewed after six months was similar to the global sample. The evaluation study improved and applied a model with 32 indicators that allowed to analyze the municipalities considering the political-organizational and tactical-operational aspects. Two hundred and four municipalities answered the questionnaire (69.1%); they were evaluated according to their respective population size. The availability of methodological procedures of studies that articulate epidemiological and evaluation methods allows generating more accurate and complete information and contribute with the design and evaluation of health policies, programs and actions.
Highlights
A versão final do questionário foi composta de 365 questões, algumas oriundas de instrumentos fechados e validados trazidos de outras pesquisas com objetivos semelhantes e outras desenhadas pelos pesquisadores conforme os objetivos do projeto
As perguntas incluídas no controle de qualidade referiam-se a tipo de parto, número de gestações anteriores, realização de consulta odontológica no pré-natal, fumo durante o período gestacional, visita à maternidade previamente ao parto, escolaridade máxima, uso de sulfato ferroso durante a gestação e realização de vacina durante o pré-natal
Comparação entre características das puérperas observadas nos registros do Sistema de Informações sobre Nascidos Vivos (SINASC) para os 31 hospitais participantes da presente pesquisa e obtidas na amostra do estudo
Summary
Foram incluídos na investigação todos os hospitais de Santa Catarina que, em 2016, realizaram ao menos 500 partos pelo SUS, o que resultou no total de 31 hospitais distribuídos em 30 diferentes municípios. Esse conjunto de instituições correspondeu a 86,2% de todos os nascimentos no estado financiados pelo SUS em 2016. O cálculo amostral foi realizado no software Stata 15. Com nível de confiança de 95%, população de 50 mil, margem de erro de 1,6 ponto percentual, prevalência estimada de 50 e 5% para recompor perdas, a amostra incluiu 3.665 mulheres. O número de entrevistas realizadas em cada hospital seguiu a distribuição proporcional de nascimentos observada em 2016
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