Abstract
BackgroundAttention to prenatal care and child delivery is important for the health of women and children, but in the Amazon these indicators tend to be historically unfavorable, in part by geographical and political isolation. In 2003 both Brazilian and Peru governments have finished paving an international road connecting remotes areas in the Brazilian Amazon to the Pacific coast in Peru.MethodsThe situation of prenatal care and child delivery with mothers of children under 5 years old living in the urban area of Assis Brasil, Acre was assessed in two cross-sectional studies performed in 2003 and 2011, corresponding to the period before and after the Pacific highway construction.ResultsIn 2003, most mothers were of black/Afro-American ethnicity, or “pardos” (the offspring of a Caucasian with a African descendant) (77.69 %), had more than 4 years of schooling (73.40 %) and had a mean age of 22.18 years. In 2011, the number of as a migration of indigenous women increased from 0 to 14.40 % of the respondents, because of migration from communities along the rivers to urban areas, with no other significant changes in maternal characteristics. No significant improvement in childbirth assistance was noticed between 1997 and 2011; only the percentage of in-hospital vaginal deliveries performed by doctors increased from 17.89 to 66.26 % (p <0.001) during this period. Access to prenatal care was associated with white ethnicity in 2003, and higher socioeconomic level and white ethnicity in 2011, while the higher number of prenatal visits was associated with higher maternal education and higher socioeconomic levels in 2011. Vaginal child delivery at a hospital facility was associated with maternal age in 2003, and year of birth, being of white ethnicity and higher level of education in 2011.ConclusionsThe indicators of prenatal care and child delivery were below the national average, showing that geographical isolation still affects women’s health care in the Amazon, despite the construction of the highway and governmental health protocols adopted during this period.
Highlights
Attention to prenatal care and child delivery is important for the health of women and children, but in the Amazon these indicators tend to be historically unfavorable, in part by geographical and political isolation
Population studied and outcomes Since the objective of the study was to evaluate changes in the municipality of Assis Brasil over the decade fostered by the paving of the road, the study was performed at two times: 2003 and 2011
The prevalence found in Assis Brasil in 2003 (93.50 %) is similar to that obtained in the North region and higher than that recorded for Acre
Summary
Attention to prenatal care and child delivery is important for the health of women and children, but in the Amazon these indicators tend to be historically unfavorable, in part by geographical and political isolation. Prenatal care is one of the most important issues in women’s health. Attention to childbirth is another very important issue, because more than 50 % of neonatal and maternal deaths occur during childbirth [2]. Other changes took place in 2006, with the governmental plan “Pact for Life,” in which basic health policies were reinforced. These policies included strengthening the public health system and decentralizing health services, aiming to reduce maternal health concerns [3]
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