Abstract
Abstract Objective: to analyze the factors associated with positive self-perceived evaluation of prenatal care among users of Primary Health Care (PHC). Methods: the analytical cross-sectional study was carried out with secondary data from the 3rd Module of the 2nd cycle (2013 / 2014) of the External Evaluation of the Improvement of Access and Quality of Primary Care Program (PMAQ-AB – Portuguese acronym), collected from users in the Basic Health Units (BHU) that joined the PMAQ-AB in Brazil. The hierarchical analysis was performed using a theoretical model and logistic regression was performed between the self-perceived evaluation (positive - very good/good or negative - regular/poor/very bad) and the sociodemographic characteristics, prenatal care and health service evaluation (p<0.05). Results: the sample consisted of 9,922 women and 81.7% rated care as very good/good. In the final model, positive evaluation was associated to women with incomplete higher education or over (OR=1.05; CI95%=1.01-1.09; p=0.010), who underwent the VDRL exam (OR=1.07; CI95%=1.01-1.14; p=0.020), consultation with the same professional (OR=1.07; CI95%=1.02-1.12; p=0.010), received guidance on the gynecological preventive exam (OR=1.05; CI95%=1.01-1.08; p=0.007), believed that guidance helped with pregnancy and child care (OR=1.24; CI95%=1.05-1.46; p=0.012), evaluated the BHU structure as very good/good (OR=1.19; CI95%=:1.14-1.24; p<0.001) and would not change BHU or team (OR=1.62; CI95%=1.48-1.68; p<0.001). Conclusion: the positive evaluation of prenatal care was associated with sociodemographic factors, prenatal care and health service evaluation.
Highlights
Prenatal is the health service that pregnant women receive from conception to the start of labor
Out of the 114,615 users interviewed in the second cycle of the PMAQ-AB external evaluation, the interviews excluded belonged to 23,412 men, 29,945 individuals over 50 years old, 6,192 women that had never been pregnant, 45,133 women that did not have their prenatal care provided by the Basic Health Units (BHU) evaluated, which resulted in 9,933 eligible women
The positive evaluation of the assistance received from the health team was associated to all the sociodemographic variables of the users (p
Summary
Prenatal is the health service that pregnant women receive from conception to the start of labor. The main objective of the prenatal care is to assist women and promote birth of healthy children by guaranteeing maternal and neonatal wellbeing.[1]. It has been proven that good quality and humanized prenatal care reduces gestational risk and complications for both mother and baby, and to guarantee that, it is necessary to facilitate the access to users, with the assistance of qualified health professionals to develop both preventive and curing activities, along with an organized service network.[2,3]. Aiming at improving the quality of the services offered to pregnant women, several health public policies have been implemented in Brazil.[4]. In 2002, the Health Ministry started the implementation of the Prenatal and Birth Humanization Program (PHPN – Portuguese acronym), aiming to improve perinatal results, with emphasis on the importance of evaluating the quality of the service available to pregnant women.[6]
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