Training for the qualification of care management for high-risk pregnant women in Amazon, Brazil

Abstract

Abstract Background Maternal care is a worldwide concern, especially at vulnerable settings, as Amazonas, Brazil, where insufficiency of training institutions and professionals and environmental issues are challenges for vulnerable pregnant women care, including indigenous and riverside population. PlanificaSUS project, which is developed nationwide aiming to support and integrate of Specialized Outpatient Care (SOC) and Primary Health Care (PHC). Objectives Between September 2022 and January 2023, the PlanificaSUS developed a training in 2 Amazonas’ municipalities to qualify work practices at PHC and SOC aiming integrality and equitable care for pregnant women. Target audience was health professionals and managers. The following care management tools were used as didactic materials: i. Clinical Guideline for Pregnancy, Childbirth and Puerperium; ii. Risk Stratification Form; iii. Care Sharing Form; and iv. Care Plan. The training last 4 hours, with 3 levels of cognitive process as learning objectives. Activity 1 (understanding): consisted of handling the presented tools and reflections based on the local reality. Activity 2 (application): participants groups simulated the use of tools in clinical cases. Activity 3 (analysis): planning actions to implement tools in local work process after training. Results 48 professionals and managers participated in the training. It was verified that participants did not know the care management tools. Preliminary 2-month results indicate that the tools were incorporated into work process of 5 PHC units. Among 167 pregnant women previously registered, 72% had been stratified using the clinical guideline and the risk stratification form. Of those, 17% were at high risk, among which 38% had the care plan and the form to share care with SOC prepared by PHC team. Conclusions The training supports care management based on population needs, allowing care qualification and greater systemic rationality, despite vulnerability and low resources. Key messages • The training enabled health professionals and managers to understand the real health needs of the population and to qualify their care practices for vulnerable pregnant women in Amazon, Brazil. • The training contributed to qualify the access and care of high-risk pregnant women and those in vulnerable situations to the specialized outpatient care integrated with the PHC in Amazon, Brazil.