Stork Network Research Articles

A casa de parto de São Sebastião/DF: Um exercício de APO em unidade do sistema único de saúde

O Centro de Parto Normal (CPN) de São Sebastião/DF, também nominado Casa de Parto de São Sebastião, é uma unidade do Sistema Único de Saúde (SUS) que oferece atendimento às gestantes de baixo risco da Região de Saúde Leste do Distrito Federal que desejam um parto humanizado na rede pública de saúde. Criada em 2001, com o objetivo de assistir e conduzir o parto normal, é composta por 4 quartos PPP (pré-parto, parto e pós-parto) e tem o intuito de atender toda a demanda da gestação ao parir, seguindo a linha de cuidados propostos pela Rede Cegonha. Em 2011, o Ministério da Saúde (MS) criou essa rede de cuidados como uma estratégia de política pública que sistematiza e institucionaliza um modelo de atenção ao parto e ao nascimento. No entanto, a ausência de infraestrutura de apoio inviabiliza as ações propostas pela rede. Sendo assim, faz-se necessária a avaliação e implementação de soluções viáveis.Com base na avaliação pós-ocupação (APO) da Casa de Parto de São Sebastião, serão avaliados o projeto existente do ponto de vista arquitetônico considerando o espaço físico e seu conforto ambiental (térmico, luminoso e sonoro), a percepção dos usuários (puérperas, acompanhantes e funcionários) por meio de aplicação de questionário e a conformidade com a legislação vigente. Tendo em vista as informações obtidas, a intenção é identificar os principais aspectos que necessitam de melhoria, visando uma arquitetura sustentável, que qualifique o ambiente.

The vulnerability of Afro-Brazilian women in perinatal care in the Unified Health System: analysis of the Active Ombudsman survey

With principles of respect to the protection and implementation of human rights, cultural, ethnic and racial diversity and also the promotion of equity, the Stork Network ensures the right to reproductive planning and continued provision of care in maternal and child health. This study sought to evaluate the Active Ombudsman Survey of the Stork Network conducted with women who had their births assisted by the Unified Health System (SUS) in 2012, in order to analyze ethnic/racial differences in prenatal and childbirth care. This descriptive study used the secondary database from the survey conducted by the SUS Ombudsman. The universe of this investigation was constituted by 253,647 women, and 50.8% self-declared themselves as brown, 35.4% white, 10.6% black 2.1% yellow, 0.6% Indians and for 0.5% race/color was not informed. Women of black/brown race appear to be worse off in socioeconomic characteristics, prenatal and childbirth care, in all variables studied, except concerning aggression and supplementary payment. Knowledge about inequalities and vulnerability of this group may serve to alert society and the government, and as a guideline for the development of policies and actions to reduce health inequalities.

User embracement and risk classification at obstetric emergency: evaluating operationalization in a maternity hospital school

Abstract Objective: To evaluate the functioning of a user embracement and risk classification service in a maternity hospital school in Recife, Pernambuco, Brazil. Method: Observational, cross-sectional, and analytical study with a quantitative approach, conducted at the "Amaury de Medeiros" Integrated Health Center of the University of Pernambuco (CISAM/UPE), in April and May 2015. The sample consisted of 377 female users and 6 nurses, with the application of Stork Network's user embracement and risk classification protocol. Results: The waiting time according to risk classification was 21.2 min; the duration time was 5 min; the waiting time according to the red priority was 3.5 min. The spontaneous demand showed that 56% of the users were classified as green priority, 60% of the users reported dissatisfaction, and 33% of the nurses received training. Conclusions: The service under analysis needs agreements and assessments to promote coping strategies.

ESTRATÉGIAS DA GESTÃO PARA IMPLANTAÇÃO DO MODELO DA REDE CEGONHA EM UMA MATERNIDADE PÚBLICA DE CURITIBA

Objetivou-se analisar estratégias adotadas para a implantação das diretrizes da Rede Cegonha, sob a perspectiva de gestores. Trata-se de uma pesquisa exploratória, de abordagem quanti-qualitativa, cuja coleta de dados ocorreu em 2015, mediante entrevistas a três gestores do nível estratégico de uma maternidade de risco habitual em uma capital do sul do Brasil. Utilizou-se o método de análise do Discurso do Sujeito Coletivo com apoio do software Qualiquantisoft®. Como resultados, emergiram as categorias, entre outras: Estratégias para implantação do Modelo Assistencial, e Estratégias para reorganização estrutural do modelo gerencial, que foram condizentes à implantação do modelo assistencial preconizado pela Rede Cegonha. Pode-se concluir, sob a luz desta pesquisa, que a proposta da gestão em implantar um modelo humanizado, pautado em evidências científicas, está em processo de construção, com avanços valiosos, empenho das equipes e valorização do profissional impulsionando as ações de mudança, concretizando a efetivação do cuidado em permanente aprimoramento.

Characterization Of Obstetric Assistance At Labor And Childbirth In Low-Risk Women On A Maternity Of Reference To Maternal And Child Health

Objectives: To describe the prevalence of the implementation of obstetric interventions for labor and birth in normal-risk women in reference to maternity Stork Network.
 Methodology: cross-sectional study was performed from April 2014 to January 2015, with 421 participants in the Maternity School Assis Chateaubriand - UFC, admitted during spontaneous or induced labor with a live fetus and single pregnancy term and their fetuses weighing between 2,500 and 4.499g. The data collection instrument was divided into blocks with sociodemographic and clinical characteristics, obstetric, data care during labor, delivery and birth, maternal morbidity, maternal outcome and obstetric practices in categories A and B from WHO and perinatal outcomes. The values ​​are presented as mean ± standard deviation.
 Results: The age ranged from 13 to 44; the average gestational age at admission was 38.9 ± 1.1 weeks; 52.2% with only one child; 8.6% had a previous cesarean section. There was 96.2% of pre-natal coverage with an average of 6.4 consultations. 76.2% had vaginal delivery. Obstetric practices in category A were more prevalent oxytocin in the third stage (97.1%), partograph (95%), non-invasive methods for pain relief (87.2%), companion (84.6%). While in section B were more of a vaginal examination at 2 hours (50.4%) and intravenous infusion (44.9%) and oxytocin in the expansion phase (28.8%). The present study had as limitations the loss of some data, which depended on the filling of third parties, which are characteristic of searches in medical records, or any documentary archive because it is a collection of secondary data.
 Conclusions: It was possible to identify that the "Good labor assistance practices" has been developed in a good proportion considered; however some practices that should be discouraged are still performed relatively frequently.

Violência obstétrica no processo de parturição em maternidades vinculadas à Rede Cegonha

Objectivesto analyze the institutional violence against women in the parturition process in maternity hospitals linked to Stork Network of Fortaleza/Cascavel. Material and MethodsThis is a descriptive study with a quantitative approach, performed in eleven maternities, medium and high complexity of the network of health care of women in the state of Ceará, composed of 11 maternity hospitals, participated in the survey 3.765 transpelvic birth mothers who were in the accommodation units set of these institutions. ResultsAbout the sociodemographic characteristics of the study participants were between 20‐34 years (62.1%), in the case of emotional support that should be offered during delivery, the participants reported that they felt the presence of visits (82.9%) in relation to the attitudes that led to feelings of hesitation the participants said they felt security (89.4%). ConclusionsThe study demonstrates the importance of an appropriate humanized care through the structure and organization of maternal and child care proposed by the stork network.

Impact of deployment of “Stork Network” in hospitalizations in the Neonatal Intensive Care Unit

Objective: to assess the impact of the deployment of “Stork Network” (Rede Cegonha) in hospitalizations in the Neonatal Intensive Care Unit. Methods: a retrospective cross-sectional study with 283 medical records of newborns hospitalized in neonatal intensive care unit before and after the implementation of Stork Network, correlating data from pregnant women with the babies’ conditions. Results: after the implementation of Stork Network, the percentage of pregnant women who performed six or more visits to the hospital increased 6.5% and the diagnosis of hypertensive disorders of pregnancy reduced 10.8%. It was also noted reduction of one week in the mean gestational age of babies and 14.4% reduction in the percentage of babies weighing ≥2500 grams. The number of deaths during hospitalization increased from 2.4% to 14.5%. Conclusion: the goal of performing screening and monitoring of risk pregnancies was reached, however, the reduction of neonatal mortality rate is still challenging.

Impact of health research on advances in knowledge, research capacity-building and evidence-informed policies: a case study on maternal mortality and morbidity in Brazil.

National health research systems aim to generate high-quality knowledge so as to maintain and promote the population's health. This study aimed to analyze the impact of maternal mortality/morbidity research funded by the Brazilian Ministry of Health and institutional partners, on the dimensions: advancing in knowledge, research capacity-building and informing decision-making, within the framework of the Canadian Academy of Health Sciences. Descriptive study based on secondary data, conducted at a public university. The advancing in knowledge dimension was estimated from the principal investigators' publication counts and h-index. Data on research capacity-building were obtained from the Ministry of Health's information system. The informing decision-making dimension was analyzed from citations in Stork Network (Rede Cegonha) documents. Between 2002 and 2010, R$ 21.6 million were invested in 128 maternal mortality/morbidity projects. Over this period, the principal investigators published 174 articles, resulting in an h-index of 35, thus showing progress in the advancing in knowledge dimension. Within the research capacity-building dimension, training of 71 students (undergraduate/postgraduate) was observed. Progress in the informing decision-making dimension was modest: 73.5% of the 117 citations in the Stork Network documents were institutional documents and norms. One of the projects funded, the 2006/7 National Demography and Health Survey, was cited in program documents. Impacts were shown in the advancing in knowledge and research capacity-building dimensions. The health research system needs to incorporate research for evidence-informed policies.

ANÁLISE DOS PARTOS VAGINAIS E CESARIANAS NO MUNICÍPIO DE GOIÂNIA-GOIÁS: antes e após a rede cegonha

As políticas de controle de mortalidade materno e infantil já vem demonstrando sinais de resposta, pelo menos no que se refere a ampliação dos recursos, acesso a saúde e politicas de humanização do parto, e dentre estas propostas está a Rede Cegonha, implantada em Goiânia em 2011.Trata-se de um estudo quantitativo analitico e descritivo realizado a partir das declaracoes de nascidos vivos, nos anos de 2010 e 2012, disponibilizadas online, com objetivo de comparar as variáveis que envolvam o parto normal e cesarianas no período que precede e procede a implantação da Rede Cegonha no município de Goiânia-GO.Os dados mostraram que não houve mudanças significativas no perfil socio-demográfico das parturientes, nas caracteristicas referentes ao local de parto, duração da gestação,número de consultas e perfil dos recen-nascidos, tanto nas mães que realizaram parto vaginal quanto nas que realizaram cesáreas. Percebeu-se tambem a importancia do preenchimento dessas informações para traçar o perfil das parturientes e dos seus recén-nascidos.Espera-se que este estudo estimule novas pesquisas de avaliação do impacto da implantação da Rede Cegonha em Goiânia.

A análise de implicação de pesquisadores em uma pesquisa-intervenção na Rede Cegonha: ferramenta da análise institucional

This qualitative study is based on institutional analysis as the methodological theoretical reference with the objective of analyzing researchers' implication during a research-intervention and the interferences caused by this analysis. The study involved researchers from courses in medicine, nursing, and dentistry at two universities and workers from a Regional Health Department in follow-up on the implementation of the Stork Network in São Paulo State, Brazil. The researchers worked together in the intervention and in analysis workshops, supported by an external institutional analysis. Two institutions stood out in the analysis: the research, established mainly with characteristics of neutrality, and management, with Taylorist characteristics. Differences between researchers and difficulties in identifying actions proper to network management and research were some of the interferences that were identified. The study concludes that implication analysis is a powerful tool for such studies.

Adequação do processo da assistência pré-natal segundo os critérios do Programa de Humanização do Pré-natal e Nascimento e Rede Cegonha

To evaluate the adequacy of the process of prenatal care according to the parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the procedures provided by the Stork Network of Unified Health System (SUS) in the microregion of Espirito Santo state, Brazil. A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing the records of 742 women during the postpartum period and of their newborns in 7 hospitals in the region chosen for the research. The information was collected, processed and analyzed by the χ² and Fisher's exact test to determine the difference in proportion between the criteria adopted by the PHPN and the Stork Network and the place of residence, family income and type of coverage of prenatal service. The level of significance was set at 5%. The parameters showing the lowest adequacy rate were quick tests and repeated exams, with frequencies around 10 and 30%, respectively, in addition to educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk management (92.6%) and the fasting plasma glucose test (91.3%) showed the best results. Adequacy was 7.4% for the PHPN, 0.4% for the Stork Network, with respect to the parameters of normal risk pregnancies, and 0 for high risk pregnancies. There was a significant difference between puerperae according to housing location regarding the execution of serology for syphilis (VDRL), anti-HIV and repeated fasting glucose tests, and monthly income influenced the execution of blood type/Rh factor tests, VDRL, hematocrit and anti-HIV test. Prenatal care in the SUS proved to be inadequate regarding the procedures required by the PHPN and Stork Network in the micro-region of a state in southeastern Brazil, especially for women of lower income, PACS users and residents of rural areas.

P6.013 Rapid HIV Diagnostic Testing in Brazil and Its Contribution Toward Reducing Vertical Transmission of HIV and Syphilis

BackgroundIn 2012, Brazil’s Ministry of Health (MoH), via its Department of STDs, AIDS and Viral Hepatitis, increased the availability of rapid testing for HIV diagnosis and syphilis screening by means...

<b> Aborto no Brasil atual: entre o direito e as políticas públicas </b> - doi: 10.5102/rbpp.v3i1.1951

This paper analyzes the formulation process and the general consequences of two recent federal public policies on women’s health: the “stork network” (rede cegonha) (Ordinance n. 1.459/2011, Health Department) and the national system of registration and monitoring of pregnant and postpartum women (Provisional Executive Order n. 557). It is showed that such programs can only be understood as tools for the effectiveness of the criminal legal provision that forbids abortion. Based on this central hypothesis, it is explored the most sensitive effects of the implementation of such documents, both in terms of recognition of social identities and resources’ distribution. In this particular, the arguments developed allow to realize that the program’s structures reinforce the social inequality and exclusion, and also incorporate a social representation of the women as a human being without autonomy.