PRIMARY CARE (PC) OF THE PREGNANCY IN LA MATANZA: EFICIENCY AND COST/BENEFIT RELATIONSHIP

Abstract

There is a high frequency of low birth weight (LBW) (12,5%) and uncontrolled pregnant women (24%) among the impovereshed population without social security in “La Matanza”. In order to modify these facts, we carried out an interventional study at “San Pedro” neiborhood. This population has 75% of family groups with unsatisfied basic needs and unsatisfactory perinatal care. The programme consisted in: 1) Primary care of all the pregnant women in the study area, 2) Family planning education, 3) A trainnig programme for sanitary agents in charge of the pregnancy and home care. A case/control study was developed after two years. The control group was selected among the pregnant women attended in the “Diego Paroissien” Hospital (La Matanza). These patients have similar social and perinatal risk factors compared with the study group. We observed in the study group a perinatal mortality (25%O) and a LBW prevalence (7,5%), lower than the frequencies observed in the control group (36%) (12,3%) (p0,01). Primary care resulted in low perinatal morbidity and mortality and hypothetically diminished the number of LBW (n:34). When porogramme costs and intensive care costs avoided were analyzed, we verified and important saving in health expenses (PC cost: 18570 dollars) (intensive care cost avoided: 53840 dollars) (saving: 35270 dollars). Conclusion: PC of pregnant women improves perinatal results in populations with poor irutial outcomes. The investiment in PC can diminish curative costs due to a decrease in LBW.