Abstract
Abstract This study aims to evaluate the Stork Network (SN), a new pattern of intergovernmental program. The method was applied through the adjusted Delphi Method, with 13 specialists. It was constituted in 3 moments. A Logical Model (LM) was elaborated, with the purpose of showing the design of the actions of the program and its main components. By consensus the Delphi Matrix of Concordance with the proposal of the Goal Image was elaborated and validated. Finally, this Matrix was used as an instrument to evaluate the degree of implementation of the program. The results show that SN is classified in the Unsatisfactory Level, in the III Macro-regional Health in Pernambuco, corroborating the irrelevance of initiatives developed to strengthen the program. It is concluded that the application of this Delphi Method was consistent with the complexity of the object, given the lack of specific models for this purpose based on new institutional relations in the regionalization of the Unified Health System (SUS, acronym in Portuguese). This study showed its implications for nursing practice in the search for solutions for patient safety in maternal and child health care, pointing out the indispensability of these professionals to make SN more effective, especially in the face of a vulnerable and disadvantaged population in the interior of the semi-arid region, in an adverse political-economic scenario.
Highlights
In Brazil, since 2000, several themes of concern in the Public Health agenda have merited relevance, including the Maternal and Child Health Care[1]
The method of this study is based on the construction of the Logic Model (LM)[19,22] as a tool for the systematic and visual representation of the program, which rationally shows the sequence of steps and relationships that lead to the expected effects[19,20], where the program theory is made explicit[21]
The recommended configuration of the objective image evaluation and the degree of implantation (GI) of the Storks Network (SN) made it possible to improve the structuring and perception of the components to evaluate the fundamentals involved and the possible links between them from the elaboration of Logical Model (LM), as it guided the proposal composition of the Delphi Matrix of Consensus for the SN sent to the experts who issued two judgments, the level of agreement with the dimensions that composed the objective Image elaborated by the authors and the GI of its fundamentals, according to these dimensions.They conceptualized the correlation of the fundamental with the dimension to which it is associated
Summary
In Brazil, since 2000, several themes of concern in the Public Health agenda have merited relevance, including the Maternal and Child Health Care[1]. In the Unified Health System (SUS), this program was articulated in view of the need to increase public expenditures for assistance to the maternal and child segment, given the worrisome health situation related to the precarious indicators of morbidity and mortality reaching this target population, associated to prenatal, childbirth and puerperium[1,2]. With this program, there was an improvement in the scenario with the increase of resources destined to qualify the attention of the mother-child binomial. The Northeast Region presents higher rates of maternal and infant morbidity and mortality in relation to the other regions of the country, leading to the prioritization of investment in this region, in order to accelerate the reduction of these inequalities[2]
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