Quality of Prenatal Care in Brazil: National Health Research 2013.

Débora Nunes Mario,Lilian Rigo,Deniz Anziliero,Fernando César Wehrmeister,Karine De Lima Sírio Boclin,Bernardo Lessa Horta,Lygia Maria Mouri Malvestio,Jeovany Martínez-Mesa

doi:10.1590/1413-81232018243.13122017

Débora Nunes Mario, Lilian Rigo + Show 6 more

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https://doi.org/10.1590/1413-81232018243.13122017

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Abstract

This study aimed to assess the adequacy of prenatal care in Brazil associated with sociodemographic determinants. The study included a data analysis from the National Health Research performed in Brazil in 2013. Two outcomes on the adequacy of prenatal care were assessed: the Kessner index modified by Takeda index that, in addition to the former, assessed whether blood pressure and weight were measured in all appointments, as well as the performance of blood and urine tests and ultrasound. Both quality indicators were assessed for Brazil and for its macro-regions. According to Outcome 1, 80.6% of women received adequate prenatal care. When adding the performance of tests (Outcome 2), the rate dropped to 71.4%. Adequate prenatal care was more frequent among white women who performed prenatal care in the private health sector. The northern region had the lowest rate of adequate prenatal care, while the southeast region showed the highest rates. Despite the extensive coverage, prenatal care in Brazil still presents inequities and low service quality, especially for women from the poorest regions of the country.

Highlights

The early start of prenatal care and its adequate execution are important to ensure maternal and fetal health and reduce their morbidity and mortality[1,2,3,4].Prenatal care coverage in Brazil was reinforced by government programs such as the Prenatal and Birth Humanization Program (Programa de Humanização no Pré-Natal e Nascimento - PHPN), established by the Ministry of Health in 2000, which aimed to improve the access, coverage, and quality of prenatal follow-up, assisted delivery, and postpartum and newborn care[5,6]
The following information were used to assess the quality of prenatal care: “Did you have six or more prenatal visits?”; “How far along in the pregnancy did you start prenatal care?”; “Was your blood pressure measured in all visits?”; “Was your weight measured in all visits?”; “Did you perform blood tests during prenatal care?”; “Did you perform urine tests during prenatal care?”; “Did you perform any ultrasound during prenatal care?”
The analyses hereby performed suggest a high rate of prenatal care coverage in Brazil

Summary

Introduction

Prenatal care coverage in Brazil was reinforced by government programs such as the Prenatal and Birth Humanization Program (Programa de Humanização no Pré-Natal e Nascimento - PHPN), established by the Ministry of Health in 2000, which aimed to improve the access, coverage, and quality of prenatal follow-up, assisted delivery, and postpartum and newborn care[5,6] According to this program, an adequate prenatal care should start up to the fourth month of pregnancy and include at least six follow-up visits, as well as blood and urine tests. An adequate prenatal care should start up to the fourth month of pregnancy and include at least six follow-up visits, as well as blood and urine tests To this plan, the Brazilian government launched in 2011 the Stork Network (Rede Cegonha), aiming to improve even more the access and quality of assistance for pregnant women and reduce maternal mortality, especially in the north and northeast regions[7,8,9]. Some factors are closely related to the adequacy of prenatal care, such as region of the country, location of residence (rural or urban area), and family income[10,11,12]

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